1891806402 NPI number — FW TOENGES & SONS, INC.

Table of content: (NPI 1891806402)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891806402 NPI number — FW TOENGES & SONS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FW TOENGES & SONS, 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:
FRED TOENGES SHOES & PEDORTHICS
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:
1891806402
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3914 W. JEFFERSON BLVD.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT WAYNE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46804-6812
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
260-484-4742
Provider Business Mailing Address Fax Number:
260-484-6368

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3914 W. JEFFERSON BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT WAYNE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46804-6812
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
260-484-4742
Provider Business Practice Location Address Fax Number:
260-484-6368
Provider Enumeration Date:
08/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TOENGES
Authorized Official First Name:
ROSS
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
260-484-4742

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 000000097076 . This is a "ANTHEM BLUE CROSS/BLUE SH" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 000000097076 . This is a "UNICARE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 000000097076 . This is a "UNITED FOOD & COMMERICIAL" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 0472740001 . This is a "TODAY'S OPTIONS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 128626500 . This is a "US DEPT OF LABOR" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 20306 . This is a "PHPNI" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 7479546 . This is a "AETNA" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 10013620A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100156320C , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 20306 . This is a "PHP" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: FRC36700 . This is a "CHILDRENS W SPECIAL HEALT" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 20306 . This is a "PHP MANAGEMENT SYSTES" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




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