1679549471 NPI number — MRS. CINDY DEUTSCHER PAC

Table of content: MS. MARIA ISABEL CASTELLANOS GONZALEZ (NPI 1164081972)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679549471 NPI number — MRS. CINDY DEUTSCHER PAC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEUTSCHER
Provider First Name:
CINDY
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PAC
Provider Gender Code:
F

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:
1679549471
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/06/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
212 N PRAIRIE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLANDREAU
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57028-1243
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-997-2471
Provider Business Mailing Address Fax Number:
605-997-2418

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
212 N PRAIRIE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLANDREAU
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57028-1243
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-997-2471
Provider Business Practice Location Address Fax Number:
605-997-2418
Provider Enumeration Date:
02/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  0369 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 559533900 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6826514 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9238073 . This is a "DAKOTACARE" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 13252 . This is a "MIDLANDS CHOICE" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 659S5DE . This is a "BCBS OF MN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 659S5DE . This is a "CC SYSTEMS BLUE PLUS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: AH9081017524 . This is a "PREFERRED ONE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 57028A002 . This is a "WPS TRICARE" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 975912 . This is a "ARAZ/AMERICA'S PPO" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 4995980 . This is a "BCBS OF SOUTH DAKOTA" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 6826513 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".




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