1487089702 NPI number — GLOBE NURSING NP PROF CORP

Table of content: (NPI 1487089702)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487089702 NPI number — GLOBE NURSING NP PROF CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GLOBE NURSING NP PROF CORP
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:
GLOBE MEDICAL SERVICES INC
Provider Other Organization Name Type Code:
4
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:
1487089702
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/04/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
640 S SUNSET AVE
Provider Second Line Business Mailing Address:
STE 102
Provider Business Mailing Address City Name:
WEST COVINA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91790-2808
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-338-9000
Provider Business Mailing Address Fax Number:
626-338-9022

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
933 S. SUNSET AVE
Provider Second Line Business Practice Location Address:
STE 105
Provider Business Practice Location Address City Name:
WEST COVINA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91790-3410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-813-1222
Provider Business Practice Location Address Fax Number:
626-813-1221
Provider Enumeration Date:
09/05/2013

Additional Information

Authorized Official

Authorized Official Last Name:
OGBEIWI
Authorized Official First Name:
OSAMAMWODE
Authorized Official Middle Name:
S.
Authorized Official Title or Position:
NP
Authorized Official Telephone Number:
626-813-1222

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  17752 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LP0808X , with the licence number: 17752 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2024 www.npivalidator.com