1144262650 NPI number — ALLIANCE PULMONARY ASSOCIATES 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 1144262650 NPI number — ALLIANCE PULMONARY ASSOCIATES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLIANCE PULMONARY ASSOCIATES 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:
1144262650
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/09/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
270 E STATE ST
Provider Second Line Business Mailing Address:
SUITE #240
Provider Business Mailing Address City Name:
ALLIANCE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-596-6560
Provider Business Mailing Address Fax Number:
330-823-6449

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
270 E STATE ST
Provider Second Line Business Practice Location Address:
SUITE #240
Provider Business Practice Location Address City Name:
ALLIANCE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-596-6560
Provider Business Practice Location Address Fax Number:
330-823-6449
Provider Enumeration Date:
06/11/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BASIT
Authorized Official First Name:
ABDUL
Authorized Official Middle Name:
BASIT
Authorized Official Title or Position:
SOLE OWNER
Authorized Official Telephone Number:
330-596-6560

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X , with the licence number:  35078091 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2209774 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".