1609259910 NPI number — TRANSITCARE

Table of content: KENNETH J. ALLAN M.D. (NPI 1780683581)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609259910 NPI number — TRANSITCARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRANSITCARE
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:
1609259910
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/06/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1230 RAYMOND RD
Provider Second Line Business Mailing Address:
SUITE 1008
Provider Business Mailing Address City Name:
JACKSON
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39204-4583
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
601-955-2949
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1230 RAYMOND RD
Provider Second Line Business Practice Location Address:
SUITE 1008
Provider Business Practice Location Address City Name:
JACKSON
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39204-4583
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-955-2949
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/06/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
POWELL
Authorized Official First Name:
JASMINE
Authorized Official Middle Name:
CHAPMAN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
601-878-2534

Provider Taxonomy Codes

  • Taxonomy code: 343900000X , with the licence number:  37653 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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