1831668367 NPI number — VHC II

Table of content: (NPI 1831668367)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831668367 NPI number — VHC II

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VHC II
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:
MCCLURE ORTHOPEDIC SURGICAL CENTER, LLC
Provider Other Organization Name Type Code:
4
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:
1831668367
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/23/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11811 N TATUM BLVD STE 3031
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHOENIX
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85028-1621
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
27-753-4133
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3329 E BELL RD STE A1-A5
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85032-2756
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-753-4133
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/14/2018

Additional Information

Authorized Official

Authorized Official Last Name:
NANCE
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
29-030-3606

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com