1801856109 NPI number — HURST MEDICAL EQUIPMENT INC

Table of content: (NPI 1801856109)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801856109 NPI number — HURST MEDICAL EQUIPMENT INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HURST MEDICAL EQUIPMENT 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:
CHOICE MEDICAL
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:
1801856109
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/30/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3325 BARTLETT BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32811-6428
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-206-0040
Provider Business Mailing Address Fax Number:
407-206-0010

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
113 WASHINGTON ST W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLESTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-930-5470
Provider Business Practice Location Address Fax Number:
304-205-0491
Provider Enumeration Date:
03/23/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GRIGGS
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
P
Authorized Official Title or Position:
CEO, PRESIDENT
Authorized Official Telephone Number:
407-206-0040

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X , with the licence number:  11244 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0206009311 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0148379000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 469196 . This is a "FED BLACK LUNG" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 87838 . This is a "MULTI PLAN" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 000212505 . This is a "BLUE CROSS" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".