1134126642 NPI number — MADY AND MULES, PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134126642 NPI number — MADY AND MULES, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MADY AND MULES, PA
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:
1134126642
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/09/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1212 YORK RD
Provider Second Line Business Mailing Address:
SUITE C-101
Provider Business Mailing Address City Name:
LUTHERVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21093-6240
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-321-0377
Provider Business Mailing Address Fax Number:
410-821-7517

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1212 YORK RD
Provider Second Line Business Practice Location Address:
SUITE C-101
Provider Business Practice Location Address City Name:
LUTHERVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21093-6240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-321-0377
Provider Business Practice Location Address Fax Number:
410-821-7517
Provider Enumeration Date:
06/30/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MULES
Authorized Official First Name:
LYNDA
Authorized Official Middle Name:
G
Authorized Official Title or Position:
PRESIDENT / CEO
Authorized Official Telephone Number:
410-321-0377

Provider Taxonomy Codes

  • Taxonomy code: 208100000X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: H370 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 6578 . This is a "BLUE CROSS FEDERAL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 6578 . This is a "BLUE CHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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