1518975150 NPI number — NORTHWEST HOSPITAL EKG READERS INC

Table of content: (NPI 1518975150)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518975150 NPI number — NORTHWEST HOSPITAL EKG READERS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTHWEST HOSPITAL EKG READERS 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:
1518975150
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/29/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 919617
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32891-9617
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-726-1808
Provider Business Mailing Address Fax Number:
954-726-1820

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2801 N STATE ROAD 7
Provider Second Line Business Practice Location Address:
- EKG READERS PANEL
Provider Business Practice Location Address City Name:
MARGATE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33063-5727
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-726-1808
Provider Business Practice Location Address Fax Number:
954-726-1820
Provider Enumeration Date:
08/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SCHULTZ
Authorized Official First Name:
NEIL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
954-973-4555

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 258864100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 45254 . This is a "BLUE CROSS/BLUE SHIELD" identifier . This identifiers is of the category "OTHER".




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