1346359551 NPI number — GROUP G CONSULTANTS INC

Table of content: (NPI 1346359551)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346359551 NPI number — GROUP G CONSULTANTS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GROUP G CONSULTANTS 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:
BOCA PHARMACY AND HOME HLTH CNTR
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:
1346359551
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/06/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
625 NE SPANISH RIVER BLVD
Provider Second Line Business Mailing Address:
STE 105
Provider Business Mailing Address City Name:
BOCA RATON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33431
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-362-4701
Provider Business Mailing Address Fax Number:
561-362-4707

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
625 NE SPANISH RVR BLVD
Provider Second Line Business Practice Location Address:
STE 105
Provider Business Practice Location Address City Name:
BOCA RATON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33431
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-362-4701
Provider Business Practice Location Address Fax Number:
561-362-4707
Provider Enumeration Date:
08/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GRABER
Authorized Official First Name:
NORBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
561-251-8136

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  PH11370 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1065831 . This is a "OTHER ID NUMBER-COMMERCIAL NUMBER" identifier . This identifiers is of the category "OTHER".




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