1629149166 NPI number — NORTH AMERICAN PAIN CONTROL LLC

Table of content: (NPI 1629149166)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629149166 NPI number — NORTH AMERICAN PAIN CONTROL LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH AMERICAN PAIN CONTROL LLC
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:
1629149166
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 931854
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44193-0004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-430-5727
Provider Business Mailing Address Fax Number:
614-430-5744

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
99 N BRICE RD
Provider Second Line Business Practice Location Address:
SUITE 270
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43213-6510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-358-7246
Provider Business Practice Location Address Fax Number:
614-358-7260
Provider Enumeration Date:
11/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HARRISON
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
614-487-8772

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  208VP0014X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 174400000X , with the licence number: 208VP0000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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