1093159428 NPI number — ALL ABOUT YOUR HEALTH 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 1093159428 NPI number — ALL ABOUT YOUR HEALTH INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALL ABOUT YOUR HEALTH 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:
ALL ABOUT YOUR HEALTH INC.
Provider Other Organization Name Type Code:
3
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:
1093159428
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1704 E GREENVILLE ST STE 1D
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANDERSON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29621-7914
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-332-8992
Provider Business Mailing Address Fax Number:
864-332-8993

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1704 E GREENVILLE ST STE 1D
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANDERSON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29621-7914
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-332-8992
Provider Business Practice Location Address Fax Number:
864-332-8993
Provider Enumeration Date:
04/29/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BERGER
Authorized Official First Name:
MEL
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
864-332-8892

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 14563 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0004X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336M0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 2140186 . This is a "PK" identifier . This identifiers is of the category "OTHER".