1487754339 NPI number — AMEHRCO ENTERPRISES, INC.

Table of content: (NPI 1487754339)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487754339 NPI number — AMEHRCO ENTERPRISES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMEHRCO ENTERPRISES, 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:
MEDFIRST PHARMACY
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:
1487754339
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 27216
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79926-7216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-595-1300
Provider Business Mailing Address Fax Number:
915-595-8657

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7878 GATEWAY BLVD E
Provider Second Line Business Practice Location Address:
102
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79915-1802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-595-1300
Provider Business Practice Location Address Fax Number:
915-595-8657
Provider Enumeration Date:
09/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KEIVAN
Authorized Official First Name:
SIAMAK
Authorized Official Middle Name:
K
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
915-595-1300

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  18965 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 3336C0003X , with the licence number: 18965 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 144748 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4588224 . This is a "NABP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 4588224 . This is a "NCPDP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 4588224 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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