1851721914 NPI number — CALHOUN CHIROPRACTIC P.C.

Table of content: (NPI 1851721914)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851721914 NPI number — CALHOUN CHIROPRACTIC P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CALHOUN CHIROPRACTIC P.C.
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:
1851721914
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/09/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
451 ANDOVER ST
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
NORTH ANDOVER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01845-5044
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-681-4500
Provider Business Mailing Address Fax Number:
978-420-4414

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
451 ANDOVER ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
NORTH ANDOVER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01845-5044
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-681-4500
Provider Business Practice Location Address Fax Number:
978-420-4414
Provider Enumeration Date:
11/26/2013

Additional Information

Authorized Official

Authorized Official Last Name:
CALHOUN
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
STANTON
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
978-681-4500

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  3062 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1235230947 . This is a "INDIVIIDUAL NPI" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 110073246/A , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: Y45837 . This is a "MEDICARE PTAN/LEGACY" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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