1356503098 NPI number — RADIATION PHYSICS INC

Table of content: (NPI 1356503098)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356503098 NPI number — RADIATION PHYSICS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RADIATION PHYSICS 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:
1356503098
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/20/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10133 BACON DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELTSVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20705-2102
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-937-4072
Provider Business Mailing Address Fax Number:
301-937-2332

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10133 BACON DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELTSVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20705-2102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-937-2332
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/25/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RUBIN
Authorized Official First Name:
LOUIS
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
301-937-4072

Provider Taxonomy Codes

  • Taxonomy code: 293D00000X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 021624800 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2198029 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 472718500 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".