1811470255 NPI number — ABORTIONCLINICS.ORG INC

Table of content: (NPI 1811470255)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811470255 NPI number — ABORTIONCLINICS.ORG INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABORTIONCLINICS.ORG 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:
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:
1811470255
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/12/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1002 W MISSION AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLEVUE
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-292-4164
Provider Business Mailing Address Fax Number:
402-291-4643

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10401 OLD GEORGETOWN ROAD
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
BETHESDA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20814
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-292-4164
Provider Business Practice Location Address Fax Number:
402-291-4643
Provider Enumeration Date:
09/12/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SOUDER
Authorized Official First Name:
CHELSEA
Authorized Official Middle Name:
Authorized Official Title or Position:
CLINIC ADMIN
Authorized Official Telephone Number:
402-292-4164

Provider Taxonomy Codes

  • Taxonomy code: 207VG0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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