1700336914 NPI number — FURSANKIM GROUP LLC

Table of content: (NPI 1700336914)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700336914 NPI number — FURSANKIM GROUP LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FURSANKIM GROUP LLC
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:
EAST2WEST ACUPUNCTURE
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:
1700336914
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/12/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22 REDWOOD TRACK TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OCALA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34472-6074
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
651-343-0262
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13940 N US HIGHWAY 441
Provider Second Line Business Practice Location Address:
OAKLAND HILL PROFESSIONAL CENTER, STE 905
Provider Business Practice Location Address City Name:
LADY LAKE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32159-8908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-343-0262
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/12/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SANGI
Authorized Official First Name:
SARANTUYA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
651-343-0262

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  AP3710 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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