1649406687 NPI number — H2U WELLNESS CENTERS, LLC

Table of content: (NPI 1649406687)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649406687 NPI number — H2U WELLNESS CENTERS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
H2U WELLNESS CENTERS, 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:
1649406687
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3322 W END AVE
Provider Second Line Business Mailing Address:
SUITE 400
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37203-1031
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-344-4401
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3322 WEST END AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-344-4401
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/04/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
JONES
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
Authorized Official Title or Position:
VP
Authorized Official Telephone Number:
615-373-7600

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2086S0129X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: DO7514 . This is a "RR MEDICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 7100095430 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".