1558836940 NPI number — CITY OF BURLINGTON

Table of content: (NPI 1558836940)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558836940 NPI number — CITY OF BURLINGTON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF BURLINGTON
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:
1558836940
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/11/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
833 S SPRUCE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BURLINGTON
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98233-2810
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-755-0531
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
350 E SHARON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BURLINGTON
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98233-2232
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-755-0531
Provider Business Practice Location Address Fax Number:
360-755-9565
Provider Enumeration Date:
10/11/2018

Additional Information

Authorized Official

Authorized Official Last Name:
SEXTON
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
V
Authorized Official Title or Position:
MAYOR
Authorized Official Telephone Number:
360-755-0531

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 29M02 . This is a "AMBULANCE LICENSE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com