1609188960 NPI number — ALCRISTA INVESTMENTS INC

Table of content: (NPI 1609188960)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609188960 NPI number — ALCRISTA INVESTMENTS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALCRISTA INVESTMENTS 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:
1609188960
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/02/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4801 GEORGE RD
Provider Second Line Business Mailing Address:
STE 140
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33634-6265
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-886-2023
Provider Business Mailing Address Fax Number:
813-886-2096

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2451 N MCMULLEN BOOTH RD
Provider Second Line Business Practice Location Address:
SUITE 246
Provider Business Practice Location Address City Name:
CLEARWATER
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33759-1356
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-886-2023
Provider Business Practice Location Address Fax Number:
813-886-2096
Provider Enumeration Date:
07/02/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
EYER
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
W
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
813-205-8536

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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