1821228578 NPI number — BLUNDY INC

Table of content: HELEN RENEE BARNETT RN (NPI 1093493348)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821228578 NPI number — BLUNDY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BLUNDY 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:
6
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:
1821228578
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/15/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4 COMMONS BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SENECA
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29678-2666
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-882-5191
Provider Business Mailing Address Fax Number:
864-882-5196

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 COMMONS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SENECA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29678-2666
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-882-5191
Provider Business Practice Location Address Fax Number:
864-882-5196
Provider Enumeration Date:
07/15/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BLUNDY
Authorized Official First Name:
ERIC
Authorized Official Middle Name:
PAUL
Authorized Official Title or Position:
PRES/DIR
Authorized Official Telephone Number:
864-882-5191

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  3444 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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