1437223393 NPI number — T&W CHIROPRACTIC SERVICES, INC.

Table of content: (NPI 1437223393)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437223393 NPI number — T&W CHIROPRACTIC SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
T&W CHIROPRACTIC 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:
HEALTH AND HARMONY WELLNESS CENTER
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:
1437223393
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/24/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6958 NEXUS CT
Provider Second Line Business Mailing Address:
STE 102
Provider Business Mailing Address City Name:
FAYETTEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28304-2648
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-864-9400
Provider Business Mailing Address Fax Number:
910-860-2417

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6958 NEXUS CT
Provider Second Line Business Practice Location Address:
STE 102
Provider Business Practice Location Address City Name:
FAYETTEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28304-2648
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-864-9400
Provider Business Practice Location Address Fax Number:
910-860-2417
Provider Enumeration Date:
11/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TINSLEY
Authorized Official First Name:
JOHNATHAN
Authorized Official Middle Name:
EDWARD
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
910-864-9400

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2684 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 890844J , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2454074 . This is a "MEDICARE PROVIDER NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 0844J . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7368199 . This is a "AETNA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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