1386060077 NPI number — AXTMAN INC

Table of content: (NPI 1386060077)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386060077 NPI number — AXTMAN INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AXTMAN 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:
HOME CARE ASSISTANCE OF SOUTH DAKOTA
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:
1386060077
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/05/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5009 S WESTERN AVE STE 220
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SIOUX FALLS
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57108-5084
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-275-9183
Provider Business Mailing Address Fax Number:
605-275-9184

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5009 S WESTERN AVE STE 220
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SIOUX FALLS
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57108-5084
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-275-9183
Provider Business Practice Location Address Fax Number:
605-275-9184
Provider Enumeration Date:
03/05/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
AXTMAN
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
DAVIS
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
605-275-9183

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , with the licence number:  DB057712 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 347C00000X , with the licence number: DB057712 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 385H00000X , with the licence number: DB057712 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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