1184813685 NPI number — FAITH CHILD CARING CENTERS, CHMC

Table of content: DR. SAMUEL JOHN LEMERIS D.M.D. (NPI 1689713737)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184813685 NPI number — FAITH CHILD CARING CENTERS, CHMC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAITH CHILD CARING CENTERS, CHMC
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:
1184813685
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
225 SMITHVILLE CHURCH RD
Provider Second Line Business Mailing Address:
SUITE 800
Provider Business Mailing Address City Name:
WARNER ROBINS
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31088-9092
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
478-987-0290
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
225 SMITHVILLE CHURCH RD
Provider Second Line Business Practice Location Address:
SUITE 800
Provider Business Practice Location Address City Name:
WARNER ROBINS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31088-9092
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
478-987-0290
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MOORE
Authorized Official First Name:
XAVIER
Authorized Official Middle Name:
FITZGERALD
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
478-256-0377

Provider Taxonomy Codes

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

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





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