1962592444 NPI number — PROGRESS INDUSTRIES

Table of content: (NPI 1962592444)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962592444 NPI number — PROGRESS INDUSTRIES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PROGRESS INDUSTRIES
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:
1962592444
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1017 E 7TH ST N
Provider Second Line Business Mailing Address:
P O BOX 1449
Provider Business Mailing Address City Name:
NEWTON
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50208-1449
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1017 E 7TH ST N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWTON
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50208-1449
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
641-791-2837
Provider Business Practice Location Address Fax Number:
641-792-0337
Provider Enumeration Date:
10/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SKOKAN
Authorized Official First Name:
DAN
Authorized Official Middle Name:
Authorized Official Title or Position:
C E O
Authorized Official Telephone Number:
641-791-2874

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 373H00000X , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 0881581 . This is a "ICF/MR - NURSING FACILITY" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 3228643 . This is a "ARO / REMEDIAL SERVICES" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 0093815 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0880682 . This is a "ICF/MR - NURSING FACILITY" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 0881599 . This is a "ICF/MR - NURSING FACILITY" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 0228643 . This is a "ARO / REMEDIAL SERVICES" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 2228643 . This is a "ARO / REMEDIAL SERVICES" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 1228643 . This is a "ARO / REMEDIAL SERVICES" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 4228643 . This is a "ARO / REMEDIAL SERVICES" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 5228643 . This is a "ARO / REMEDIAL SERVICES" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




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