1164421913 NPI number — IHS ACQUISITION XXX, 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 1164421913 NPI number — IHS ACQUISITION XXX, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
IHS ACQUISITION XXX, 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:
6
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:
1164421913
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/09/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
05/19/2010
NPI Reactivation Date:
09/09/2010

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3101 GAYLORD PKWY
Provider Second Line Business Mailing Address:
MAILSTOP 1E-E144
Provider Business Mailing Address City Name:
FRISCO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75034-8655
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-365-8300
Provider Business Mailing Address Fax Number:
469-365-8320

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2525 PERIMETER PLACE DR
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37214-3674
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-331-2011
Provider Business Practice Location Address Fax Number:
615-331-2033
Provider Enumeration Date:
07/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
MARK
Authorized Official Middle Name:
O.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
469-365-8300

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  0000003088 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1452829 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




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