1346371762 NPI number — CENTRAL EMERGENCY PHYSICIANS, PSC

Table of content: MARISOL PAGE HARRINGTON MD (NPI 1528802667)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346371762 NPI number — CENTRAL EMERGENCY PHYSICIANS, PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRAL EMERGENCY PHYSICIANS, PSC
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:
1346371762
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/07/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1827
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40588-1827
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-277-8179
Provider Business Mailing Address Fax Number:
859-277-9320

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1740 NICHOLASVILLE RD
Provider Second Line Business Practice Location Address:
CENTRAL BAPTIST HOSPITAL-EMERGENCY ROOM
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40503-1431
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-260-6100
Provider Business Practice Location Address Fax Number:
859-277-9320
Provider Enumeration Date:
03/08/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
IRWIN
Authorized Official First Name:
LELAND
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
859-277-8179

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 012485700 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".