1609801851 NPI number — ARP PHOENIX

Table of content: (NPI 1609801851)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609801851 NPI number — ARP PHOENIX

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARP PHOENIX
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:
ARP PHOENIX
Provider Other Organization Name Type Code:
4
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:
1609801851
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/21/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 16367
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28816-0367
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-252-8957
Provider Business Mailing Address Fax Number:
828-255-8028

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
257 BILTMORE AVE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28801-4131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-254-2700
Provider Business Practice Location Address Fax Number:
828-254-1524
Provider Enumeration Date:
07/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WARREN
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
A
Authorized Official Title or Position:
DIRECTOR BUSINESS SERVICES
Authorized Official Telephone Number:
828-252-9191

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  MHL011050 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YA0400X , with the licence number: MHL011275 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YM0800X , with the licence number: MHL011050 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 5900180 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5900179 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6005277 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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