1336286384 NPI number — NBN INFUSIONS INC

Table of content: (NPI 1336286384)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336286384 NPI number — NBN INFUSIONS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NBN INFUSIONS 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:
1336286384
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 PIN OAK LN
Provider Second Line Business Mailing Address:
UNIT 250
Provider Business Mailing Address City Name:
CHERRY HILL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08003-1632
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-669-0217
Provider Business Mailing Address Fax Number:
856-424-8913

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 PIN OAK LN
Provider Second Line Business Practice Location Address:
UNIT 250
Provider Business Practice Location Address City Name:
CHERRY HILL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08003-1630
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-669-0217
Provider Business Practice Location Address Fax Number:
856-424-8913
Provider Enumeration Date:
01/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BOETTCHER
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
KARL
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
856-669-0217

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 28R500454200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336H0001X , with the licence number: 28R500454200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0004052000 . This is a "PERSONAL CHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 19968 . This is a "UNIVERSITY HEALTH PLANS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 34546 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 43512 . This is a "AMERIGROUP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0004052000 . This is a "KEYSTONE HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 116388 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 4533402 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3193327 . This is a "NCPDP" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: A1000663 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 3193327 . This is a "NAPB NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0004052000 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1036043 . This is a "HORIZON NJ HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: BU0000115-01 . This is a "AMERICHOICE NJ" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2K0662 . This is a "HEALTHNET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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