1912987249 NPI number — ASSISTIVE TECHNOLOGY SOLUTIONS, LLC

Table of content: (NPI 1912987249)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912987249 NPI number — ASSISTIVE TECHNOLOGY SOLUTIONS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSISTIVE TECHNOLOGY SOLUTIONS, LLC
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:
1912987249
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 330730
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37203-7505
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-327-1780
Provider Business Mailing Address Fax Number:
615-327-0117

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1915 CHARLOTTE AVE
Provider Second Line Business Practice Location Address:
SUITE 225
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37203-2130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-327-1960
Provider Business Practice Location Address Fax Number:
615-327-0117
Provider Enumeration Date:
01/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
STEVE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
615-327-1960

Provider Taxonomy Codes

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

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

  • Identifier: 4034042 . This is a "TN CARE SELECT #" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 1454623 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 90008996 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4780840001 . This is a "PALMETTO REGION C #" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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