1376599399 NPI number — RUTH W GUYER M.D., PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376599399 NPI number — RUTH W GUYER M.D., PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RUTH W GUYER M.D., PA
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:
ANCHOR MEDICAL ASSOCIATES
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:
1376599399
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/04/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 12457
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JACKSONVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28546-2457
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-353-4991
Provider Business Mailing Address Fax Number:
910-353-6410

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
217 STATION ST
Provider Second Line Business Practice Location Address:
EFFECTIVE 1 JULY 2010, CHANGE TO 1 MATTHEW COURT
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28546-6304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-353-4991
Provider Business Practice Location Address Fax Number:
910-353-6410
Provider Enumeration Date:
05/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GUYER
Authorized Official First Name:
RUTH
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
910-353-4991

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  31024 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1174537096 . This is a "INDIV NPI" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 37979 . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7937979 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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