1891988309 NPI number — ROSA L THOMAS HOMES

Table of content: MISS KAVITA FABIAN SERRAO MA (NPI 1346327434)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891988309 NPI number — ROSA L THOMAS HOMES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROSA L THOMAS HOMES
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:
1891988309
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/20/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
483 CARIBOU RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28803-1616
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-275-3651
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
137 BROAD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28801-1901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-257-4949
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/20/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MCKAY
Authorized Official First Name:
KATHLEEN
Authorized Official Middle Name:
A
Authorized Official Title or Position:
MEMBER MANAGER
Authorized Official Telephone Number:
828-275-3651

Provider Taxonomy Codes

  • Taxonomy code: 311ZA0620X , with the licence number:  FCL011216 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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