1568479285 NPI number — LINDA L GALE PA-C

Table of content: LINDA L GALE PA-C (NPI 1568479285)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568479285 NPI number — LINDA L GALE PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GALE
Provider First Name:
LINDA
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

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:
1568479285
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 602373
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28260-2373
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-250-2833
Provider Business Mailing Address Fax Number:
828-651-6559

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
472 RANKIN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARION
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28752-6568
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-652-1400
Provider Business Practice Location Address Fax Number:
828-659-7829
Provider Enumeration Date:
08/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  001728 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , with the licence number: 0010-05736 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 10728 . This is a "CONNECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 2V7941 . This is a "HEALTH NET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: TIN . This is a "CORVEL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 290001728CT01 . This is a "ANTHEM BC/BS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: TIN . This is a "NORHTEAST HEALTH DIRECT" identifier . This identifiers is of the category "OTHER".
  • Identifier: TIN . This is a "MULTIPLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: TIN . This is a "BERLEY ADMINISTRARTOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: G132277 . This is a "INTEGRATED HEALTH PLAN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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