1992952097 NPI number — HEALTHLINK ASSOCIATES, PLLC

Table of content: (NPI 1992952097)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992952097 NPI number — HEALTHLINK ASSOCIATES, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTHLINK ASSOCIATES, PLLC
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:
HEALTHLINK ASSOCIATES, PLLC
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:
1992952097
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 20263
Provider Second Line Business Mailing Address:
C/O RMS
Provider Business Mailing Address City Name:
FERNDALE
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
313-850-8435
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6071 W OUTER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48235-2624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-850-8435
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/20/2008

Additional Information

Authorized Official

Authorized Official Last Name:
BARGAINER
Authorized Official First Name:
FELISA
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL BILLING SUPERVISOR
Authorized Official Telephone Number:
313-850-8435

Provider Taxonomy Codes

  • Taxonomy code: 173000000X , with the licence number:  SK062464 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 4539733-10 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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