1184853707 NPI number — J J FARIBO TAXI

Table of content: (NPI 1184853707)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184853707 NPI number — J J FARIBO TAXI

Organization/Personal Information

Employer Identification Number (EIN):
N/A
Provider Organization Name:
J J FARIBO TAXI
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:
1184853707
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/02/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
412 PRAIRIE AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FARIBAULT
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55021
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-291-8294
Provider Business Mailing Address Fax Number:
507-332-2789

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
412 PRAIRIE AVE SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FARIBAULT
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55021-5735
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-291-8294
Provider Business Practice Location Address Fax Number:
507-332-2789
Provider Enumeration Date:
07/02/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
UGLAND
Authorized Official First Name:
JULIE
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
OWNER/OPERATOR
Authorized Official Telephone Number:
507-291-8284

Provider Taxonomy Codes

  • Taxonomy code: 344600000X , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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