1235559816 NPI number — DW AUTO AND MOBILITY

Table of content: (NPI 1235559816)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235559816 NPI number — DW AUTO AND MOBILITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DW AUTO AND MOBILITY
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:
DW AUTO & MOBILITY
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:
1235559816
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/22/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1101 LAKEVIEW AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65201-4659
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-441-0744
Provider Business Mailing Address Fax Number:
573-441-0745

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
802 MIDPOINT DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
O FALLON
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63366-5945
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-441-0744
Provider Business Practice Location Address Fax Number:
573-441-0745
Provider Enumeration Date:
04/22/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DALY
Authorized Official First Name:
BRIDGET
Authorized Official Middle Name:
RENEE
Authorized Official Title or Position:
AR MANAGER
Authorized Official Telephone Number:
573-441-0744

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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