1386044980 NPI number — ANIMAL HEALTH INTERNATIONAL, INC.

Table of content: (NPI 1386044980)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386044980 NPI number — ANIMAL HEALTH INTERNATIONAL, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANIMAL HEALTH INTERNATIONAL, 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:
ANIMAL HEALTH INTERNATIONAL, INC.
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:
1386044980
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/02/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2915 ROCKY MOUNTAIN AVE STE 400
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOVELAND
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80538-9048
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
8-854-7664
Provider Business Mailing Address Fax Number:
970-346-2312

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4305 N WESTPORT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SIOUX FALLS
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57107-0711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-584-5145
Provider Business Practice Location Address Fax Number:
970-553-8750
Provider Enumeration Date:
09/02/2014

Additional Information

Authorized Official

Authorized Official Last Name:
WIGFIELD
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
SENIOR DIRECTOR OF PHARMACY OPS
Authorized Official Telephone Number:
612-306-2721

Provider Taxonomy Codes

  • Taxonomy code: 3336S0011X , with the licence number:  100-1933 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2147613 . This is a "PK" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com