1467752287 NPI number — ADVANCED INTEGRATED MEDICATIONS

Table of content: (NPI 1467752287)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467752287 NPI number — ADVANCED INTEGRATED MEDICATIONS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED INTEGRATED MEDICATIONS
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:
1467752287
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/26/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11500 N STEMMONS FWY
Provider Second Line Business Mailing Address:
SUITE 158
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75229-2184
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:
469-464-1235

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11500 N STEMMONS FWY
Provider Second Line Business Practice Location Address:
SUITE 158
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75229-2184
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-619-3005
Provider Business Practice Location Address Fax Number:
469-464-1235
Provider Enumeration Date:
10/26/2010

Additional Information

Authorized Official

Authorized Official Last Name:
PATEL
Authorized Official First Name:
GOPESH
Authorized Official Middle Name:
Authorized Official Title or Position:
PHARMACIST-IN-CHARGE
Authorized Official Telephone Number:
469-236-2977

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  27200 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com