1902319734 NPI number — THE RIZEN ONE MINISTRIES,INC.

Table of content: DR. ARNOLD STEVEN ZIDE O.D. (NPI 1043205834)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902319734 NPI number — THE RIZEN ONE MINISTRIES,INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE RIZEN ONE MINISTRIES,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:
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:
1902319734
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/30/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1911 GRAYSON HWY # 8-153
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAYSON
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30017-1245
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-615-0105
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2158 AUSTIN COMMON WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DACULA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30019-7778
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-615-0105
Provider Business Practice Location Address Fax Number:
585-615-0105
Provider Enumeration Date:
11/15/2017

Additional Information

Authorized Official

Authorized Official Last Name:
DAWSON
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
CEO/PRESIDENT
Authorized Official Telephone Number:
585-615-0105

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000000000 . This is a "OTHER" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".




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