1356348049 NPI number — ENVIRONMENTAL HEALTH SCIENCE, INC

Table of content: (NPI 1356348049)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356348049 NPI number — ENVIRONMENTAL HEALTH SCIENCE, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ENVIRONMENTAL HEALTH SCIENCE, 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:
HEALTH SCIENCE
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:
1356348049
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
418 WALL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PRINCETON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08540-1504
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-841-8923
Provider Business Mailing Address Fax Number:
609-924-0793

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
418 WALL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRINCETON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08540-1504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-841-8923
Provider Business Practice Location Address Fax Number:
609-924-0793
Provider Enumeration Date:
07/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
GOLDBERG
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
S
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
800-841-8923

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: 0539155 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4582298 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 82389200 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0010971660002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1540696 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 931114 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000G4575 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 54128 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0000599416 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3155200 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 91779049 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01130189 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 05353058 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0440878 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1160001 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".




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