1811274475 NPI number — 4 HIS MAJESTY INVESTMENT SOLUTIONS

Table of content: (NPI 1811274475)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811274475 NPI number — 4 HIS MAJESTY INVESTMENT SOLUTIONS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
4 HIS MAJESTY INVESTMENT SOLUTIONS
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:
4 HIS MAJESTY BEAUTY SUPPLY
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:
1811274475
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/10/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
510 GARNET TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94513-2641
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
925-550-7604
Provider Business Mailing Address Fax Number:
925-240-6300

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2180 REESE ST
Provider Second Line Business Practice Location Address:
BLDG 1385
Provider Business Practice Location Address City Name:
LACKLAND A F B
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78236-1042
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-550-7604
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/10/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BERRY
Authorized Official First Name:
FRED
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
925-550-7604

Provider Taxonomy Codes

  • Taxonomy code: 332BC3200X , with the licence number:  40013907 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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