1619976446 NPI number — IHS ACQUISITION XXX, INC.

Table of content: (NPI 1619976446)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619976446 NPI number — IHS ACQUISITION XXX, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
IHS ACQUISITION XXX, 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:
US BIOSERVICES
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:
1619976446
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/24/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3101 GAYLORD PKWY
Provider Second Line Business Mailing Address:
MAILSTOP 1E-E144
Provider Business Mailing Address City Name:
FRISCO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75034-8655
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-365-8129
Provider Business Mailing Address Fax Number:
469-365-8274

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
109 CHELSEA PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOOTHWYN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19061-1305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-400-9549
Provider Business Practice Location Address Fax Number:
469-365-8274
Provider Enumeration Date:
07/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
RATLIFF
Authorized Official First Name:
KELLY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
469-365-8202

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  PP413902L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336H0001X , with the licence number: PP413902L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 0016822280005 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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