1164848214 NPI number — AMICABLE HEALTHCARE, INC.

Table of content: (NPI 1164848214)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164848214 NPI number — AMICABLE HEALTHCARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMICABLE HEALTHCARE, 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:
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:
1164848214
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/13/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15220 32ND AVENUE SOUTH SUITEB
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEATAC
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98188-2179
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-246-0550
Provider Business Mailing Address Fax Number:
206-246-0562

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15220 32ND AVE S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEATAC
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98188-2179
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-246-0550
Provider Business Practice Location Address Fax Number:
206-246-0562
Provider Enumeration Date:
03/13/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
AMOSUN
Authorized Official First Name:
OLADAPO
Authorized Official Middle Name:
Authorized Official Title or Position:
OPERATION DIRECTOR
Authorized Official Telephone Number:
206-444-4810

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  IHS.FS.00000215 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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