1225085715 NPI number — WEST COAST NEONATOLOGY, INC.

Table of content: (NPI 1225085715)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225085715 NPI number — WEST COAST NEONATOLOGY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WEST COAST NEONATOLOGY, 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:
1225085715
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/20/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 946298
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30394-6298
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-767-4378
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 5TH ST S
Provider Second Line Business Practice Location Address:
5TH FLOOR
Provider Business Practice Location Address City Name:
ST PETERSBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-767-4313
Provider Business Practice Location Address Fax Number:
727-767-4391
Provider Enumeration Date:
05/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SCHULHOF
Authorized Official First Name:
KRISTY
Authorized Official Middle Name:
ALICIA
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
727-898-7451

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VM0101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2080N0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 251391900 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 251391901 . This is a "RPICC GROUP NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 251391908 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 251391911 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 251391912 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 251391915 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 39761 . This is a "BC/BS GROUP NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 251391905 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 251391909 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: CY392A . This is a "MEDICARE GROUP NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 251391914 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com