1649502469 NPI number — CONSTO TRADES LLP

Table of content: (NPI 1649502469)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649502469 NPI number — CONSTO TRADES LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CONSTO TRADES LLP
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:
CORD-3 AMBULETTE SERVICES
Provider Other Organization Name Type Code:
3
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:
1649502469
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/03/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4621 S COOPER ST
Provider Second Line Business Mailing Address:
#131-352
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76017-5866
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-691-1595
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4621 S COOPER ST
Provider Second Line Business Practice Location Address:
#131-352
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76017-5866
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-691-1595
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/03/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
AJAYI
Authorized Official First Name:
OLUGBENGA
Authorized Official Middle Name:
B
Authorized Official Title or Position:
GENERAL PARTNER
Authorized Official Telephone Number:
817-691-1595

Provider Taxonomy Codes

  • Taxonomy code: 343900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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