1124367487 NPI number — SEVEN SEAS DISTRIBUTION AND MANUFACTURING

Table of content: (NPI 1124367487)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124367487 NPI number — SEVEN SEAS DISTRIBUTION AND MANUFACTURING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SEVEN SEAS DISTRIBUTION AND MANUFACTURING
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:
NOVATECH MEDICAL DEVICES
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:
1124367487
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/06/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2620 S MARYLAND PKWY STE 14
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89109-1692
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-571-1846
Provider Business Mailing Address Fax Number:
702-974-1651

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11643 TELEGRAPH RD STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA FE SPRINGS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90670-3680
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-571-1846
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/06/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WATSON
Authorized Official First Name:
TYLER
Authorized Official Middle Name:
Authorized Official Title or Position:
SALES
Authorized Official Telephone Number:
800-571-1846

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  E05802820109 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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