1376711473 NPI number — EMPIRE SCANNING SERVICES, INC

Table of content: (NPI 1376711473)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376711473 NPI number — EMPIRE SCANNING SERVICES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMPIRE SCANNING SERVICES, 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:
CORVITALS
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:
1376711473
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/19/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 270
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MALVERNE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11565-0270
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-559-3413
Provider Business Mailing Address Fax Number:
631-271-2009

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
789 DEER PARK AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH BABYLON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11703-4311
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-401-9998
Provider Business Practice Location Address Fax Number:
800-559-3413
Provider Enumeration Date:
02/12/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BOTH
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
W
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
800-559-3413

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 97Z301 . This is a "ALLIED HEALTH GROUP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: G1153641 . This is a "OXFORD HEALTH PLANS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0X00NZ7915 . This is a "PHYSICIANS HEALTH SERVICES" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 97Z301 . This is a "NEW YORK MEDICARE EMPIRE (NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: EM097Z3010 . This is a "BLUE CROSS BLUE SHIELD OF NEW YORK" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".