1235346487 NPI number — ARP PHOENIX

Table of content: IXIA FERRAN RN BSN RN (NPI 1366808354)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235346487 NPI number — ARP PHOENIX

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARP PHOENIX
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:
1235346487
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 16367
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28816-0367
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-252-8957
Provider Business Mailing Address Fax Number:
828-255-8028

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
425 LINDA VISTA DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HENDERSONVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28792-2748
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-693-7377
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
TAX
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
828-254-2700

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)

  • Identifier: 8304404Q , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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