1831341577 NPI number — NATIOAL COMPOUNDING INSTITUTE INC

Table of content: (NPI 1831341577)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831341577 NPI number — NATIOAL COMPOUNDING INSTITUTE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIOAL COMPOUNDING INSTITUTE 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:
NATIOAL COMPOUNDING INSTITUTE INC
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:
1831341577
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/30/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
250 E YALE LOOP
Provider Second Line Business Mailing Address:
SUITE C
Provider Business Mailing Address City Name:
IRVINE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92604-4697
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
866-624-6241
Provider Business Mailing Address Fax Number:
866-615-5352

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1851 LANGLEY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IRVINE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92614-5623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-624-6241
Provider Business Practice Location Address Fax Number:
866-615-5352
Provider Enumeration Date:
10/14/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SULIR-SAADEH
Authorized Official First Name:
TINA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRES
Authorized Official Telephone Number:
949-551-7195

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  PHY48441 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336M0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336S0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 5632270 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".




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