1144866799 NPI number — BHS PHYSICIANS NETWORK INC

Table of content: (NPI 1144866799)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144866799 NPI number — BHS PHYSICIANS NETWORK INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BHS PHYSICIANS NETWORK 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:
NORTHEAST ORTHOPAEDICS & SPORTS MEDICINE
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:
1144866799
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/30/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5730
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELFAST
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04915-5700
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-323-7336
Provider Business Mailing Address Fax Number:
888-864-4428

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8715 VILLAGE DR STE 120
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78217-5425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-477-5151
Provider Business Practice Location Address Fax Number:
210-477-5152
Provider Enumeration Date:
11/19/2019

Additional Information

Authorized Official

Authorized Official Last Name:
RASMUS
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
Authorized Official Title or Position:
VP, CFO TPR TENET
Authorized Official Telephone Number:
469-893-2532

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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