1710038617 NPI number — ROBERT F TOBIN AND ASSOCIATES INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710038617 NPI number — ROBERT F TOBIN AND ASSOCIATES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBERT F TOBIN AND ASSOCIATES 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:
TOBIN EYE INSTITUTE
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:
1710038617
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
03/20/2007
NPI Reactivation Date:
09/20/2007

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1823 CHASE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FALLS CITY
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68355-2020
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-245-2616
Provider Business Mailing Address Fax Number:
402-245-2114

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1823 CHASE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FALLS CITY
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68355-2020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-245-2616
Provider Business Practice Location Address Fax Number:
402-245-2114
Provider Enumeration Date:
01/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
TOBIN
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
F
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
816-279-1363

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  12232 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: CD3325 . This is a "RR MEDICARE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 10024950600 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1161580005 . This is a "CIGNA DMERC" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 0430314 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1161580001 . This is a "CIGNA DMERC" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: CU0525 . This is a "RR MEDICARE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 10024950900 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




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