1396069217 NPI number — AAA MEDICAL SOLUTIONS INC

Table of content: (NPI 1396069217)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396069217 NPI number — AAA MEDICAL SOLUTIONS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AAA MEDICAL SOLUTIONS 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:
1396069217
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/13/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
412 S KING AVE
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
MIDDLETON
Provider Business Mailing Address State Name:
ID
Provider Business Mailing Address Postal Code:
83644-5294
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
208-585-2568
Provider Business Mailing Address Fax Number:
208-585-6292

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
412 S KING AVE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
MIDDLETON
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83644-5294
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-585-2568
Provider Business Practice Location Address Fax Number:
208-585-6292
Provider Enumeration Date:
03/22/2010

Additional Information

Authorized Official

Authorized Official Last Name:
HALE
Authorized Official First Name:
AARON
Authorized Official Middle Name:
DANIEL
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
208-585-2568

Provider Taxonomy Codes

  • Taxonomy code: 227800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1396069217 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2751531 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3810021964 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1396069217 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200749210A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 55975 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1396069217 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4207211 00 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10026133700 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1396069217 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1396069217 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0052729 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1396069217 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1396069217 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200405430 , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".




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