1497853923 NPI number — CITY OF LANETT

Table of content: MICHAEL KENNETH ROSNER MD (NPI 1952397671)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497853923 NPI number — CITY OF LANETT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF LANETT
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:
6
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:
1497853923
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/20/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 290
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LANETT
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36863-0290
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-644-5225
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 N LANIER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANETT
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36863-2019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-644-5225
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ALLEN
Authorized Official First Name:
JOHNNY
Authorized Official Middle Name:
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
334-644-5225

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  171 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 590000497 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 051053874 . This is a "BLUE CROSS BLUE SHIELD AL" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 000053874 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com