1538454509 NPI number — MINISTRIES OF JESUS CHRIST

Table of content: (NPI 1538454509)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538454509 NPI number — MINISTRIES OF JESUS CHRIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MINISTRIES OF JESUS CHRIST
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:
JC MINISTRIES
Provider Other Organization Name Type Code:
5
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:
1538454509
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3317 19TH ST SW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEHIGH ACRES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33976-3556
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-831-3932
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3317 19TH ST SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEHIGH ACRES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33976-3556
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-831-3932
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/17/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CADET
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
VP
Authorized Official Telephone Number:
239-240-7774

Provider Taxonomy Codes

  • Taxonomy code: 343800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 343900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 344600000X , with the licence number: 02020 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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