1972550580 NPI number — NOCH PHYSICIAN BILLING COMPANY LLC

Table of content: (NPI 1972550580)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972550580 NPI number — NOCH PHYSICIAN BILLING COMPANY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NOCH PHYSICIAN BILLING COMPANY LLC
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:
1972550580
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/17/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 30516
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LANSING
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48909-8016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
616-844-4528
Provider Business Mailing Address Fax Number:
616-847-5608

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1309 SHELDON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRAND HAVEN
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49417-2404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
616-844-4528
Provider Business Practice Location Address Fax Number:
616-847-5608
Provider Enumeration Date:
05/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RUCH
Authorized Official First Name:
JENNY
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLING CYCLE ANALYST
Authorized Official Telephone Number:
616-844-4510

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 900020778 . This is a "PRIORITY HEALTH" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: DF4619 . This is a "MEDICARE RR GRP" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 050G01452 . This is a "BCBS NP GROUP" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 080G011310 . This is a "BCBSM MD/DO GRP" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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