1750704532 NPI number — NOTUS IMAGING AND RESEARCH LABORATORIES

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 1750704532 NPI number — NOTUS IMAGING AND RESEARCH LABORATORIES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NOTUS IMAGING AND RESEARCH LABORATORIES
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:
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:
1750704532
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/29/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
560 W 800 N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OREM
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84057-3746
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-225-6246
Provider Business Mailing Address Fax Number:
801-225-1525

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
280 RIVER PARK DR
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
PROVO
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84604-5764
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-225-6246
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/29/2014

Additional Information

Authorized Official

Authorized Official Last Name:
BURGON
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
801-701-6507

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com