1285876706 NPI number — NATIONAL PARK SERVICE

Table of content: (NPI 1285876706)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285876706 NPI number — NATIONAL PARK SERVICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONAL PARK SERVICE
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:
LAKE MEAD NATIONAL RECREATION AREA
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:
1285876706
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/14/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
555 S STATE ROUTE 64
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
WILLIAMS
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
86046-5013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
928-679-2171
Provider Business Mailing Address Fax Number:
866-248-1073

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 NEVADA HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOULDER CITY
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-754-5607
Provider Business Practice Location Address Fax Number:
928-754-5614
Provider Enumeration Date:
03/30/2009

Additional Information

Authorized Official

Authorized Official Last Name:
MURPHY
Authorized Official First Name:
DIRK
Authorized Official Middle Name:
Authorized Official Title or Position:
MOJAVE DISTRICT RANGER
Authorized Official Telephone Number:
928-754-5607

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  NOT REQUIRED ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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