1275524001 NPI number — ZYGO INDUSTRIES, INC.

Table of content: (NPI 1275524001)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275524001 NPI number — ZYGO INDUSTRIES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ZYGO INDUSTRIES, 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:
1275524001
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1008
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97207-1008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-684-6006
Provider Business Mailing Address Fax Number:
503-684-6011

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16260 SW UPPER BOONES FERRY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97224-7220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-684-6006
Provider Business Practice Location Address Fax Number:
503-684-6011
Provider Enumeration Date:
11/01/2005

Additional Information

Authorized Official

Authorized Official Last Name:
LITZAU
Authorized Official First Name:
ROB
Authorized Official Middle Name:
A
Authorized Official Title or Position:
CONTRACTS MANAGER
Authorized Official Telephone Number:
503-684-6006

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: 004197861 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 221226 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9055419 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9166950 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4226875 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 11484800 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200429950A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 290714300 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 90256017 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: DME02225F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00867116 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 009810290 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0174219 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200303460A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: S6108 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1544191 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200013800A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".




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