1164486593 NPI number — CARDIOLOGY PHYSICIANS ASSOCIATES

Table of content: (NPI 1164486593)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164486593 NPI number — CARDIOLOGY PHYSICIANS ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARDIOLOGY PHYSICIANS ASSOCIATES
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:
PIEDMONT CARDIOLOGY ASSOCIATES
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:
1164486593
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/01/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2660 TATE BLVD SE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HICKORY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28602-1465
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-261-0009
Provider Business Mailing Address Fax Number:
828-261-0109

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2660 TATE BLVD SE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HICKORY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28602-1465
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-261-0009
Provider Business Practice Location Address Fax Number:
828-261-0109
Provider Enumeration Date:
04/13/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PASPA
Authorized Official First Name:
PHILIP
Authorized Official Middle Name:
A
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
828-261-0009

Provider Taxonomy Codes

  • Taxonomy code: 207RI0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 8901068 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01068 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: CE1827 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".