1144466707 NPI number — GROWTH PROCESS INTEGRATION, INCORPORATED

Table of content: (NPI 1144466707)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144466707 NPI number — GROWTH PROCESS INTEGRATION, INCORPORATED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GROWTH PROCESS INTEGRATION, INCORPORATED
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:
1144466707
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/31/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3300 N MESQUITE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COCHISE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85606-8729
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-826-0299
Provider Business Mailing Address Fax Number:
520-826-0030

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3300 N MESQUITE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COCHISE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85606-8729
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-826-0299
Provider Business Practice Location Address Fax Number:
520-826-0030
Provider Enumeration Date:
12/31/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BORDERS
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
ANGELO
Authorized Official Title or Position:
PRESIDENT/CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
520-826-0299

Provider Taxonomy Codes

  • Taxonomy code: 103G00000X , with the licence number:  3861 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TA0400X , with the licence number: 3861 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TA0700X , with the licence number: 3861 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: 3861 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103TC2200X , with the licence number: 3861 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TE1100X , with the licence number: 3861 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TF0000X , with the licence number: 3861 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TF0200X , with the licence number: 3861 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TH0004X , with the licence number: 3861 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TH0100X , with the licence number: 3861 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TP0814X , with the licence number: 3861 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TP2701X , with the licence number: 3861 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TR0400X , with the licence number: 3861 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: 3861 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 146D00000X , with the licence number: 3861 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 11233203 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3861 . This is a "LICENSE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 1275696924 . This is a "INDIVIDUAL NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0810002999 . This is a "LICENSE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".