1376574533 NPI number — ZILMED, INC.

Table of content: (NPI 1376574533)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376574533 NPI number — ZILMED, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ZILMED, 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:
1376574533
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6823 HIGHWAY 311
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SELLERSBURG
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47172-1801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-246-9809
Provider Business Mailing Address Fax Number:
812-246-9826

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6823 HIGHWAY 311
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SELLERSBURG
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47172-1801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-246-9809
Provider Business Practice Location Address Fax Number:
812-246-9826
Provider Enumeration Date:
07/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SHETH
Authorized Official First Name:
JAYESH
Authorized Official Middle Name:
T
Authorized Official Title or Position:
OWNER/PHYSICIAN
Authorized Official Telephone Number:
812-246-9809

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 555285870A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: DG2180 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 200872280A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 500141 . This is a "PASSPORT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 65944605 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 78904190 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100041590 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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