1184017501 NPI number — NRMI, LLC

Table of content: (NPI 1184017501)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184017501 NPI number — NRMI, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NRMI, LLC
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:
D/B/A NEURORESTORATIVE MICHIGAN
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:
1184017501
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/03/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
137 HOLTON WHITEHALL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITEHALL
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49461-9543
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
231-893-1462
Provider Business Mailing Address Fax Number:
231-894-5855

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
137 HOLTON WHITEHALL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITEHALL
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49461-9543
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
231-893-1462
Provider Business Practice Location Address Fax Number:
231-894-5855
Provider Enumeration Date:
03/10/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CRUZ
Authorized Official First Name:
SERGIO
Authorized Official Middle Name:
P
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
781-708-9444

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320700000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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