1093967218 NPI number — CASCADES NURSING, LLC

Table of content: (NPI 1093967218)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093967218 NPI number — CASCADES NURSING, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CASCADES NURSING, LLC
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:
BANYAN GREENVILLE NURSING SERVICES, LLC
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:
1093967218
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/14/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 FOUNTAINVIEW TERRACE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENVILLE
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29607-4033
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-528-5502
Provider Business Mailing Address Fax Number:
864-528-5550

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 FOUNTAINVIEW TERRACE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENVILLE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29607-4033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-528-5502
Provider Business Practice Location Address Fax Number:
864-528-5550
Provider Enumeration Date:
10/21/2008

Additional Information

Authorized Official

Authorized Official Last Name:
THOMPSON
Authorized Official First Name:
DONALD
Authorized Official Middle Name:
O.
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
704-246-1616

Provider Taxonomy Codes

  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 310400000X , with the licence number: CRC-1490 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 311500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 314000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 314000000X , with the licence number: NCF-0956 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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