1164421913 NPI number — IHS ACQUISITION XXX, INC.

Table of content: (NPI 1164421913)

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:
US BIOSERVICES
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:
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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