1225135064 NPI number — GSP PHARMACEUTICAL ENTEREPRISES, INC.

Table of content: (NPI 1225135064)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225135064 NPI number — GSP PHARMACEUTICAL ENTEREPRISES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GSP PHARMACEUTICAL ENTEREPRISES, 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:
ALISAL PHARMACY LTC
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:
1225135064
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/19/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
323 N SANBORN RD
Provider Second Line Business Mailing Address:
B
Provider Business Mailing Address City Name:
SALINAS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93905-2247
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
323 N SANBORN RD
Provider Second Line Business Practice Location Address:
B
Provider Business Practice Location Address City Name:
SALINAS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93905-2247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-484-7321
Provider Business Practice Location Address Fax Number:
831-424-0197
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BASRAI
Authorized Official First Name:
GURPARTAP
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
831-424-7321

Provider Taxonomy Codes

  • Taxonomy code: 3336L0003X , with the licence number:  PHY47597 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 5623803 . This is a "OTHER ID NUMBER-COMMERCIAL NUMBER" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com