1699975284 NPI number — TAYLOR ENTERPRISES 2, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699975284 NPI number — TAYLOR ENTERPRISES 2, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TAYLOR ENTERPRISES 2, INC.
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:
DBA FOOT SOLUTIONS - COTTONWOOD
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:
1699975284
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/07/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1560 E CHERRY ST
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
COTTONWOOD
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
86326-3435
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
928-634-8283
Provider Business Mailing Address Fax Number:
928-649-1914

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1560 E CHERRY ST
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
COTTONWOOD
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86326-3435
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-634-8283
Provider Business Practice Location Address Fax Number:
928-649-1914
Provider Enumeration Date:
07/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
TAYLOR
Authorized Official First Name:
ROD
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
928-634-8283

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  20174041 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com