1003963513 NPI number — ADVANCED ORTHOPEDIC SERVICES, INC.

Table of content: (NPI 1003963513)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003963513 NPI number — ADVANCED ORTHOPEDIC SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED ORTHOPEDIC SERVICES, 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:
1003963513
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:
680 FALMOUTH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HYANNIS
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02601-2318
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-771-5050
Provider Business Mailing Address Fax Number:
508-771-1563

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
680 FALMOUTH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HYANNIS
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02601-2318
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-771-5050
Provider Business Practice Location Address Fax Number:
508-771-1563
Provider Enumeration Date:
01/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
JANULAITIS
Authorized Official First Name:
ERDVILIS
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
508-771-5050

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 000000034435 . This is a "BMC HEALTHNET NORWOOD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 801021 . This is a "TUFTS PROVIDER NUMBER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 700357 . This is a "HPHC PROVIDER NUMBER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 247054 . This is a "BLUE CROSS PROVIDER NUMB" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1530135 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: S010100 . This is a "CHAMPUS PROVIDER NUMBER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000024332 . This is a "BMC HEALTHNET HYANNIS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000034434 . This is a "BMC HEALTHNET FALM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com