1205063872 NPI number — TODD A. RICHARDSON D.C. P.A.

Table of content: (NPI 1205063872)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205063872 NPI number — TODD A. RICHARDSON D.C. P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TODD A. RICHARDSON D.C. P.A.
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:
ADVANCED CHIROPRACTIC OF DELAWARE
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:
1205063872
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/29/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
727 N MARKET ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILMINGTON
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19801-4935
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-427-2990
Provider Business Mailing Address Fax Number:
302-427-2994

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
727 N MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19801-4935
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-427-2990
Provider Business Practice Location Address Fax Number:
302-427-2994
Provider Enumeration Date:
06/22/2009

Additional Information

Authorized Official

Authorized Official Last Name:
RICHARDSON
Authorized Official First Name:
TODD
Authorized Official Middle Name:
ALAN
Authorized Official Title or Position:
OWNER/CHIROPRACTOR
Authorized Official Telephone Number:
302-427-2990

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  F1-0000462 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 111N00000X , with the licence number: F1-0000658 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 2102080 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2420880000 . This is a "AMERIHEALTH HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2882144 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2102080 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 326083 . This is a "COVENTRY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 510392121 . This is a "BLUE CROSS BLUE SHEILD OF DELAWARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1755641 . This is a "AMERIHEALTH PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7098137 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".




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