1427614627 NPI number — DR. JOHN'S MEDICAL SOLUTIONS, INC.

Table of content: SUSANNE BRANDT N.P. (NPI 1669735510)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427614627 NPI number — DR. JOHN'S MEDICAL SOLUTIONS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. JOHN'S 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:
1427614627
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/13/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
315 SPRINGHOUSE CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRANKLIN
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37067-5834
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-791-6247
Provider Business Mailing Address Fax Number:
615-794-9792

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1840 W 48TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DAVENPORT
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52806-4642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
563-370-3111
Provider Business Practice Location Address Fax Number:
563-748-2551
Provider Enumeration Date:
05/13/2019

Additional Information

Authorized Official

Authorized Official Last Name:
KELLENBERGER
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
M
Authorized Official Title or Position:
VICE PRESIDENT OPERATIONS
Authorized Official Telephone Number:
563-370-3111

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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