1114045390 NPI number — S&S DEVELOPMENT

Table of content: (NPI 1114045390)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114045390 NPI number — S&S DEVELOPMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
S&S DEVELOPMENT
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:
S&S - BARTHOLOMEW
Provider Other Organization Name Type Code:
3
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:
1114045390
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3600 S NOLAND RD
Provider Second Line Business Mailing Address:
SUITE H
Provider Business Mailing Address City Name:
INDEPENDENCE
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64055-3382
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-231-4235
Provider Business Mailing Address Fax Number:
816-461-2205

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3600 S NOLAND RD
Provider Second Line Business Practice Location Address:
SUITE H
Provider Business Practice Location Address City Name:
INDEPENDENCE
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64055-3382
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-231-4235
Provider Business Practice Location Address Fax Number:
816-461-2205
Provider Enumeration Date:
03/27/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SANWOGOU
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
NAPO
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
816-231-4235

Provider Taxonomy Codes

  • Taxonomy code: 320900000X , with the licence number:  8000046 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 320900000X , with the licence number: 8001600 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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