1871521534 NPI number — DR. THOMAS M HANRAHAN DC

Table of content: DR. THOMAS M HANRAHAN DC (NPI 1871521534)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871521534 NPI number — DR. THOMAS M HANRAHAN DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HANRAHAN
Provider First Name:
THOMAS
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
M

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:
1871521534
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 TRUMBULL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT CLAIR
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48079-5339
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-329-9121
Provider Business Mailing Address Fax Number:
810-329-3914

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 TRUMBULL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT CLAIR
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48079-5339
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-329-9121
Provider Business Practice Location Address Fax Number:
810-329-3914
Provider Enumeration Date:
06/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2301005229 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 950G411210 . This is a "BCBS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: TH005229 . This is a "BCBS PIN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: P30215F . This is a "BCN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1982117 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 350031579 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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