1235681099 NPI number — PURCELL HOLDINGS, L.L.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235681099 NPI number — PURCELL HOLDINGS, L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PURCELL HOLDINGS, L.L.C.
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:
6
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:
1235681099
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/27/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6710 OXON HILL RD
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
OXON HILL
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20745-1117
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-205-7188
Provider Business Mailing Address Fax Number:
240-414-1253

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1800 DIAGONAL RD
Provider Second Line Business Practice Location Address:
SUITE 600
Provider Business Practice Location Address City Name:
ALEXANDRIA
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22314-2840
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-205-7188
Provider Business Practice Location Address Fax Number:
240-414-1253
Provider Enumeration Date:
10/27/2016

Additional Information

Authorized Official

Authorized Official Last Name:
PURCELL
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
Authorized Official Title or Position:
BOARD CHAIRMAN
Authorized Official Telephone Number:
240-205-7188

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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