1689624272 NPI number — JMNB STARPLUS EMS LTD

Table of content: (NPI 1689624272)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689624272 NPI number — JMNB STARPLUS EMS LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JMNB STARPLUS EMS LTD
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:
1689624272
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/15/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2552
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCKINNEY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75070-8172
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-452-7101
Provider Business Mailing Address Fax Number:
469-519-0109

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
330 INDUSTRIAL BLVD
Provider Second Line Business Practice Location Address:
101
Provider Business Practice Location Address City Name:
MCKINNEY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75069-7305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-452-7101
Provider Business Practice Location Address Fax Number:
469-519-0109
Provider Enumeration Date:
05/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WALDRON
Authorized Official First Name:
BRITTON
Authorized Official Middle Name:
KELLY
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
469-452-7101

Provider Taxonomy Codes

  • Taxonomy code: 343900000X , with the licence number:  800026 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 343800000X , with the licence number: 800026 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 341600000X , with the licence number: 800026 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X , with the licence number: 800026 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: AMB759 . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 173391701 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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