1851306583 NPI number — HANSEN MEDICAL PC

Table of content: (NPI 1851306583)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851306583 NPI number — HANSEN MEDICAL PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HANSEN MEDICAL PC
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:
HANSEN MEDICAL PC
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:
1851306583
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/03/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3016 W FAIDLEY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND ISLAND
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68803
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
308-381-8546
Provider Business Mailing Address Fax Number:
308-381-8550

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3016 W FAIDLEY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRAND ISLAND
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
308-381-8546
Provider Business Practice Location Address Fax Number:
308-381-8550
Provider Enumeration Date:
07/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
REIMERS
Authorized Official First Name:
CONNIE
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
308-381-8546

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 080104974 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 272911 . This is a "IND" identifier . This identifiers is of the category "OTHER".
  • Identifier: 275317 . This is a "IND" identifier . This identifiers is of the category "OTHER".
  • Identifier: 267431 . This is a "IND" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 10025386100 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 35930 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 38552 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00998 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 080183038 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 10025353400 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 970015612 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".




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