1225106784 NPI number — MARUTI CORPORATION

Table of content: (NPI 1225106784)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225106784 NPI number — MARUTI CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
N/A
Provider Organization Name:
MARUTI CORPORATION
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:
TRINITY FAMILY HEALTH CARE
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:
1225106784
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/12/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6233 RIDGE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORT RICHEY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34668-6743
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-845-3333
Provider Business Mailing Address Fax Number:
727-845-3308

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6233 RIDGE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORT RICHEY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34668-6743
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-845-3333
Provider Business Practice Location Address Fax Number:
727-845-3308
Provider Enumeration Date:
12/01/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SHAH
Authorized Official First Name:
SAURINKUMAR
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
727-845-3333

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  ME 83711 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: ========= . This is a "TAX ID" identifier . This identifiers is of the category "OTHER".