1790958916 NPI number — PLUS MANAGEMENT SERVICES INC

Table of content: (NPI 1790958916)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790958916 NPI number — PLUS MANAGEMENT SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLUS MANAGEMENT SERVICES 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:
BATON ROUGE MEDICAL & REHAB
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:
1790958916
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/12/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3737 SHAWNEE ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIMA
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45806-1618
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-230-9150
Provider Business Mailing Address Fax Number:
888-545-1020

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2440 BATON ROUGE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIMA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45805-5104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-331-2273
Provider Business Practice Location Address Fax Number:
419-331-2205
Provider Enumeration Date:
04/09/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SAFFLE
Authorized Official First Name:
GEORGIANA
Authorized Official Middle Name:
MAXINE
Authorized Official Title or Position:
SR. VICE PRESIDENT
Authorized Official Telephone Number:
419-225-9018

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  4766 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2758994 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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