1447353826 NPI number — RMA - OPERATING, INC.

Table of content: (NPI 1447353826)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447353826 NPI number — RMA - OPERATING, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RMA - OPERATING, 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:
REGIONAL MEDICAL ASSOCIATES
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:
1447353826
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/27/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
83 WELLNESS WAY LN.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BENTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42025-7156
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-527-8601
Provider Business Mailing Address Fax Number:
270-527-9615

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
83 WELLNESS WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BENTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42025-7156
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-527-8601
Provider Business Practice Location Address Fax Number:
270-527-9615
Provider Enumeration Date:
09/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WARNING
Authorized Official First Name:
BRADLEY
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
PRACTICE ADMINISTRATOR
Authorized Official Telephone Number:
270-252-3212

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  20835 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 18412 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207Q00000X , with the licence number: 39144 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP2300X , with the licence number: 5503P , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP2300X , with the licence number: 4803P , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP2300X , with the licence number: 4819P , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 65935306 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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