1639161086 NPI number — ARC OF BELLINGHAM LP

Table of content: (NPI 1639161086)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639161086 NPI number — ARC OF BELLINGHAM LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARC OF BELLINGHAM LP
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:
BELLINGHAM SURGERY 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:
1639161086
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/16/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2980 SQUALICUM PKWY
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
BELLINGHAM
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98225-1880
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-671-6933
Provider Business Mailing Address Fax Number:
360-671-0196

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2980 SQUALICUM PKWY
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98225-1880
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-671-6933
Provider Business Practice Location Address Fax Number:
360-671-0196
Provider Enumeration Date:
08/19/2005

Additional Information

Authorized Official

Authorized Official Last Name:
LAPE
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
F
Authorized Official Title or Position:
FACILITY ADMINISTRATOR
Authorized Official Telephone Number:
360-671-6933

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  NONE , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: FX00055791 . This is a "NON PHARMACY FIRM" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 7095573 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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