1720120991 NPI number — MISS APRIL RENEE MCFARLAND MCD,CCC-SLP

Table of content: MISS APRIL RENEE MCFARLAND MCD,CCC-SLP (NPI 1720120991)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720120991 NPI number — MISS APRIL RENEE MCFARLAND MCD,CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCFARLAND
Provider First Name:
APRIL
Provider Middle Name:
RENEE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
MCD,CCC-SLP
Provider Gender Code:
F

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:
1720120991
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/07/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2424 DOUBLE CHURCHES RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31909-2741
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
706-324-6112
Provider Business Mailing Address Fax Number:
706-596-8259

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2424 DOUBLE CHURCHES RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31909-2741
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-324-6112
Provider Business Practice Location Address Fax Number:
706-596-8259
Provider Enumeration Date:
02/13/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  006165 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 52136326 . This is a "BLUE CROSS BLUE SHIELD OF GA" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 723286140A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".