1700950110 NPI number — THERAPEUTIC SOLUTIONS, LLC

Table of content: (NPI 1700950110)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700950110 NPI number — THERAPEUTIC SOLUTIONS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THERAPEUTIC SOLUTIONS, LLC
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:
1700950110
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/04/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1346 OLD BRIDGE RD STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WOODBRIDGE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22192-2742
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-494-4991
Provider Business Mailing Address Fax Number:
703-490-9964

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1346 OLD BRIDGE RD. STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WOODBRIDGE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22192-2485
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-494-4991
Provider Business Practice Location Address Fax Number:
703-490-9964
Provider Enumeration Date:
11/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SMILEY
Authorized Official First Name:
ANGELIA
Authorized Official Middle Name:
LYNETTE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
703-494-4991

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  0701003454 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 177301 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: J2680001 . This is a "CAREFIRST" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 238333 . This is a "KAISER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 010179866 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 537972000 . This is a "MAGELLAN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1386746246 . This is a "INDIVIDUAL NPI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 7418169 . This is a "UNKNOWN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 3102506 . This is a "MAMSI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 530294 . This is a "NCPPO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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