1851497416 NPI number — ASSURED PHARMACIES, 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 1851497416 NPI number — ASSURED PHARMACIES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSURED PHARMACIES, 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:
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:
1851497416
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/16/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2595 DALLAS PKWY
Provider Second Line Business Mailing Address:
#206
Provider Business Mailing Address City Name:
FRISCO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75034
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-668-7394
Provider Business Mailing Address Fax Number:
866-232-1680

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2431 N. TUSTIN AVE
Provider Second Line Business Practice Location Address:
UNIT L
Provider Business Practice Location Address City Name:
SANTA ANA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-667-1980
Provider Business Practice Location Address Fax Number:
714-667-1981
Provider Enumeration Date:
09/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SCHNEIDEREIT
Authorized Official First Name:
MIKE
Authorized Official Middle Name:
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
570-332-5355

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  PHY46504 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 5601061 . This is a "NCPDP" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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