1639274137 NPI number — NORTHERN ARM & HAND CENTER, INC.

Table of content: (NPI 1639274137)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639274137 NPI number — NORTHERN ARM & HAND CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTHERN ARM & HAND CENTER, INC.
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:
6
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:
1639274137
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1420 LONDON RD
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
DULUTH
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55805-2433
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
218-728-3774
Provider Business Mailing Address Fax Number:
218-728-3640

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1420 LONDON RD
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
DULUTH
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55805-2433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-728-3774
Provider Business Practice Location Address Fax Number:
218-728-3640
Provider Enumeration Date:
09/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NIELAND
Authorized Official First Name:
RUSSELL
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
218-728-3774

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  1049 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 7699 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X , with the licence number: 102280 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X , with the licence number: 102903 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XH1200X , with the licence number: 102309 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XH1200X , with the licence number: 101418 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X , with the licence number: 101379 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 7979 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251H1200X , with the licence number: 1734 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 42B46NO . This is a "BCBS MINNESOTA GROUP" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 41222100 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 32B70NO . This is a "BCBS OF MINNESOTA GROUP" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 671517600 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 37B96NO . This is a "BCBS MINNESOTA DME" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 508372900 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".




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