1598987604 NPI number — WILLIAM J ALFIERI D.C., P.C.

Table of content: (NPI 1598987604)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598987604 NPI number — WILLIAM J ALFIERI D.C., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAM J ALFIERI D.C., P.C.
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:
ALFIERI CHIROPRACTIC CLINIC
Provider Other Organization Name Type Code:
3
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:
1598987604
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
925 W MILHAM AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTAGE
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49024-1248
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
269-327-8990
Provider Business Mailing Address Fax Number:
269-327-6214

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
925 W MILHAM AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTAGE
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49024-1248
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
269-327-8990
Provider Business Practice Location Address Fax Number:
269-327-6214
Provider Enumeration Date:
05/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ALFIERI
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
JOSEPH
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
269-327-8990

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  WM004080 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 764733 . This is a "FIRST HEALTH" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 649415 . This is a "ACN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 138342 . This is a "PREFERRED CHOICES PPO" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0C95034 . This is a "MEDICARE PART B" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 4430054 . This is a "IBA" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 4430054 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0C95034 . This is a "MEDICARE ID TYPE UNSPECIF" identifier . This identifiers is of the category "OTHER".
  • Identifier: 155514 . This is a "GREAT LAKES HEALTH PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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