1730223280 NPI number — CENTERPOINT MEDICAL SERVICES, INC.

Table of content: (NPI 1730223280)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730223280 NPI number — CENTERPOINT MEDICAL SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTERPOINT MEDICAL SERVICES, 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:
CENTER POINT MEDICAL CENTER INC
Provider Other Organization Name Type Code:
4
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:
1730223280
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/24/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13420 DOUBLETREE CIRCLE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WELLINGTON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33414
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-844-7699
Provider Business Mailing Address Fax Number:
561-842-8261

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4152 W BLUE HERON BLVD
Provider Second Line Business Practice Location Address:
123
Provider Business Practice Location Address City Name:
RIVIERA BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33404-4811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-844-7699
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WALKER
Authorized Official First Name:
MONICA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/PHYSICIAN
Authorized Official Telephone Number:
561-506-9754

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  ME0047109 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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