1124267000 NPI number — MARLIND STILES PLC

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 1124267000 NPI number — MARLIND STILES PLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARLIND STILES PLC
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:
1124267000
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/13/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9772 W YEARLING RD
Provider Second Line Business Mailing Address:
STE # A1600
Provider Business Mailing Address City Name:
PEORIA
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85383-1380
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-491-0739
Provider Business Mailing Address Fax Number:
480-777-1345

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9772 W YEARLING RD
Provider Second Line Business Practice Location Address:
STE # A1600
Provider Business Practice Location Address City Name:
PEORIA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85383-1380
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-491-0739
Provider Business Practice Location Address Fax Number:
480-777-1345
Provider Enumeration Date:
02/17/2009

Additional Information

Authorized Official

Authorized Official Last Name:
STILES
Authorized Official First Name:
MARLIND
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
480-491-0739

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  D6957 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: Z129129 . This is a "MEDICARE PTAN" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




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