1427122589 NPI number — DR. RICHARD F. BUCK LLC

Table of content: (NPI 1427122589)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427122589 NPI number — DR. RICHARD F. BUCK LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. RICHARD F. BUCK LLC
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:
CHIROPRACTIC FAMILY CARE
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:
1427122589
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/24/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5606 SECOR RD
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
TOLEDO
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43623-1935
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-474-1002
Provider Business Mailing Address Fax Number:
419-474-1002

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5606 SECOR RD
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
TOLEDO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43623-1935
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-474-1002
Provider Business Practice Location Address Fax Number:
419-474-1002
Provider Enumeration Date:
11/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BUCK
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
F
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
419-474-1002

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC 1472 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 10169 . This is a "PARAMOUNT" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0746483 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 13360559300 . This is a "BWC" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 137712 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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