1316950306 NPI number — STATE OF FRANKLIN BILLING SERVICES, INC

Table of content: (NPI 1316950306)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316950306 NPI number — STATE OF FRANKLIN BILLING SERVICES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STATE OF FRANKLIN BILLING 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:
COLE'S MEDICAL SERVICES
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:
1316950306
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/09/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
313 E SPRINGBROOK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JOHNSON CITY
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37601-1770
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-929-3232
Provider Business Mailing Address Fax Number:
423-929-3231

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
313 E SPRINGBROOK DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOHNSON CITY
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37601-1770
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-929-3232
Provider Business Practice Location Address Fax Number:
423-929-3231
Provider Enumeration Date:
08/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
COLE
Authorized Official First Name:
CHARLES
Authorized Official Middle Name:
FILLMORE
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
423-929-3232

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X , with the licence number:  0000000895 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0040869 . This is a "WASHINGTON COUNTY CLERK" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 0206009378 . This is a "BOARD OF PHARMACY" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 0000000895 . This is a "DEPARTMENT OF HEALTH" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 0000002459 . This is a "BOARD OF PHARMACY" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 104757631 . This is a "TENNESSEE DEPARTMENT OF REVENUE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 1455105 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 122153 . This is a "CITY OF JOHNSON CITY BUSINESS LICENSE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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