1083791024 NPI number — DRS SCHINDLER & DEIS PC

Table of content: (NPI 1083791024)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083791024 NPI number — DRS SCHINDLER & DEIS PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DRS SCHINDLER & DEIS PC
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:
Provider Other Organization Name Type Code:
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:
1083791024
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 277
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GARRISON
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58540-0277
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-463-2224
Provider Business Mailing Address Fax Number:
701-463-2192

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
151 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GARRISON
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58540-0277
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-463-2224
Provider Business Practice Location Address Fax Number:
701-463-2192
Provider Enumeration Date:
11/01/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SCHINDLER
Authorized Official First Name:
KEITH
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
701-463-2224

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  397 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: DEI11845 . This is a "BCBS OF ND" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: SCH7191 . This is a "BCBS OF ND" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: SCH870397 . This is a "ND VISION SERVICES" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: 70486 . This is a "BCBS OF ND" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: 60453 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".
  • Identifier: 60629 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".
  • Identifier: DEI870517 . This is a "ND VISION SERVICES" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".