1013027242 NPI number — D&A DISSOLVING, INC.

Table of content: (NPI 1013027242)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013027242 NPI number — D&A DISSOLVING, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
D&A DISSOLVING, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DARR & ASSOCIATES, INC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013027242
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/22/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
319 W CHARLOTTE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CENTREVILLE
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49032-9657
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
269-271-5207
Provider Business Mailing Address Fax Number:
574-289-4327

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
218 S FRANCES ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH BEND
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46617-3004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
574-232-5815
Provider Business Practice Location Address Fax Number:
574-289-4327
Provider Enumeration Date:
08/30/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RILEY
Authorized Official First Name:
PAMELA
Authorized Official Middle Name:
RAE DEANE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
269-271-5208

Provider Taxonomy Codes

  • Taxonomy code: 237600000X , with the licence number:  23002137A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 237600000X , with the licence number: 3501002824 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237600000X , with the licence number: 23002216A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100280770A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 540A402560 . This is a "BCBS MI HEARING AIDS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 804742301 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 640A426010 . This is a "BCBS MI AUDIOLOGY" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 200122530A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000391214 . This is a "ANTHEM AUDIOLOGY/AIDS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 000000247031 . This is a "ANTHEM AUDIOLOGY /AIDS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200469120A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 903366906 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".