1184870743 NPI number — MAGIC WHEELS INC.

Table of content: (NPI 1184870743)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184870743 NPI number — MAGIC WHEELS INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MAGIC WHEELS 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:
1184870743
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3837 13TH AVE W
Provider Second Line Business Mailing Address:
SUITE 104
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98119-1354
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-282-0760
Provider Business Mailing Address Fax Number:
206-282-0765

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3837 13TH AVE W
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98119-1354
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-282-0760
Provider Business Practice Location Address Fax Number:
206-282-0765
Provider Enumeration Date:
08/14/2008

Additional Information

Authorized Official

Authorized Official Last Name:
BAECHLER
Authorized Official First Name:
PHIL
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
866-624-4294

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: V797P-3144M . This is a "VETERANS ADMINISTRATION FEDERAL SUPPLY SERVICES CONTRACT" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com