1689931537 NPI number — ALLIANCE FOR CHILDHOOD DISEASES

Table of content: (NPI 1689931537)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689931537 NPI number — ALLIANCE FOR CHILDHOOD DISEASES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLIANCE FOR CHILDHOOD DISEASES
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:
CHILDREN'S SPECIALTY CENTER OF NEVADA II
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:
1689931537
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3121 S MARYLAND PKWY
Provider Second Line Business Mailing Address:
SUITE NO. 302
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89109-2302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-732-1493
Provider Business Mailing Address Fax Number:
702-732-1404

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
540 W PLUMB LN
Provider Second Line Business Practice Location Address:
SUITE NO. 200
Provider Business Practice Location Address City Name:
RENO
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89509-3683
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-657-8981
Provider Business Practice Location Address Fax Number:
775-657-8317
Provider Enumeration Date:
04/17/2012

Additional Information

Authorized Official

Authorized Official Last Name:
LOGAN
Authorized Official First Name:
ANNETTE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
702-732-0232

Provider Taxonomy Codes

  • Taxonomy code: 207SG0201X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2080P0207X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2080P0216X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2024 www.npivalidator.com