1174236780 NPI number — THE DRIVE MASTER CO 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 1174236780 NPI number — THE DRIVE MASTER CO INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE DRIVE MASTER CO 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:
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:
1174236780
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/08/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
37 DANIEL RD W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAIRFIELD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07004-2521
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-808-9709
Provider Business Mailing Address Fax Number:
973-808-9713

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
37 DANIEL RD W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRFIELD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07004-2521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-808-9709
Provider Business Practice Location Address Fax Number:
973-808-9713
Provider Enumeration Date:
12/28/2022

Additional Information

Authorized Official

Authorized Official Last Name:
RUPRECHT
Authorized Official First Name:
PETER
Authorized Official Middle Name:
BARTLETT
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
973-808-9709

Provider Taxonomy Codes

  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0923028 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com