1831166354 NPI number — TACOMA HYPERBARIC BILLING, LLC

Table of content: (NPI 1831166354)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831166354 NPI number — TACOMA HYPERBARIC BILLING, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TACOMA HYPERBARIC BILLING, LLC
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:
1831166354
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 64992
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UNIVERSITY PLACE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98464-0992
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-535-0140
Provider Business Mailing Address Fax Number:
253-537-4184

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1717 SO J ST
Provider Second Line Business Practice Location Address:
ST JOSEPH MEDICAL CENTER- HYPERBARIC UNIT & WOUND CLINI
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-627-4101
Provider Business Practice Location Address Fax Number:
253-426-6450
Provider Enumeration Date:
03/02/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SADIQ
Authorized Official First Name:
RAHEELA
Authorized Official Middle Name:
Authorized Official Title or Position:
MEMBER LLC
Authorized Official Telephone Number:
253-223-9333

Provider Taxonomy Codes

  • Taxonomy code: 207PE0005X , with the licence number:  MD00037438 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 602069905 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: MD00037438 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2083P0011X , with the licence number: 602069905 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 7106768 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".