1306849534 NPI number — JOINT TECHNOLOGY INC

Table of content: (NPI 1306849534)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306849534 NPI number — JOINT TECHNOLOGY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOINT TECHNOLOGY 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:
1306849534
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/05/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
919 S BRYANT AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDMOND
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73034-5743
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-348-6457
Provider Business Mailing Address Fax Number:
405-348-6871

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
919 S BRYANT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDMOND
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73034-5743
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-348-6457
Provider Business Practice Location Address Fax Number:
405-348-6871
Provider Enumeration Date:
05/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
VERNER
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
D
Authorized Official Title or Position:
EXECUTIVE ASSISTANT
Authorized Official Telephone Number:
405-348-6457

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: 43585060 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1478857 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 927014 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 009990865 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0574202 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10025124400 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1435997 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100811640A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 144928201 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 626124101 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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