1174679195 NPI number — NORMATIVE SERVICES, INC.

Table of content: (NPI 1174679195)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174679195 NPI number — NORMATIVE SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORMATIVE SERVICES, 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:
1174679195
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/23/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5 LANE LANE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHERIDAN
Provider Business Mailing Address State Name:
WY
Provider Business Mailing Address Postal Code:
82801-8630
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
307-674-6878
Provider Business Mailing Address Fax Number:
307-674-7781

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5 LANE LANE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHERIDAN
Provider Business Practice Location Address State Name:
WY
Provider Business Practice Location Address Postal Code:
82801-8630
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
307-674-6878
Provider Business Practice Location Address Fax Number:
307-674-7781
Provider Enumeration Date:
01/25/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HINES
Authorized Official First Name:
DEANNE
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
ACCT SUPERVISOR
Authorized Official Telephone Number:
307-674-6878

Provider Taxonomy Codes

  • Taxonomy code: 322D00000X , with the licence number:  6190 , registered in the state of WY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 118971902 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010501921 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0320502 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".