1336286384 NPI number — NBN INFUSIONS INC

Table of content: DR. HENRY DOUGLAS TODD M.D. (NPI 1699066951)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336286384 NPI number — NBN INFUSIONS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NBN INFUSIONS 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:
1336286384
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 PIN OAK LN
Provider Second Line Business Mailing Address:
UNIT 250
Provider Business Mailing Address City Name:
CHERRY HILL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08003-1632
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-669-0217
Provider Business Mailing Address Fax Number:
856-424-8913

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 PIN OAK LN
Provider Second Line Business Practice Location Address:
UNIT 250
Provider Business Practice Location Address City Name:
CHERRY HILL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08003-1630
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-669-0217
Provider Business Practice Location Address Fax Number:
856-424-8913
Provider Enumeration Date:
01/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BOETTCHER
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
KARL
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
856-669-0217

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 28R500454200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336H0001X , with the licence number: 28R500454200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0004052000 . This is a "PERSONAL CHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 19968 . This is a "UNIVERSITY HEALTH PLANS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 34546 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 43512 . This is a "AMERIGROUP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0004052000 . This is a "KEYSTONE HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 116388 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 4533402 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3193327 . This is a "NCPDP" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: A1000663 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 3193327 . This is a "NAPB NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0004052000 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1036043 . This is a "HORIZON NJ HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: BU0000115-01 . This is a "AMERICHOICE NJ" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2K0662 . This is a "HEALTHNET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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