1932431772 NPI number — SAMUEL J. PIPES, D.O., INC.

Table of content: (NPI 1932431772)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932431772 NPI number — SAMUEL J. PIPES, D.O., INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAMUEL J. PIPES, D.O., 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:
SAMUEL PIPES, D.O., INC.
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:
1932431772
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/05/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5975 MAHONING AVE NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WARREN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44483-1190
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-847-7217
Provider Business Mailing Address Fax Number:
330-847-0563

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5975 MAHONING AVE NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WARREN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44483-1190
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-847-7217
Provider Business Practice Location Address Fax Number:
330-847-0563
Provider Enumeration Date:
02/04/2010

Additional Information

Authorized Official

Authorized Official Last Name:
PIPES
Authorized Official First Name:
SAMUEL
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
330-847-7217

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  34002108 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000160426 . This is a "UNISON" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000130557 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0256977 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4610331 . This is a "AETNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 791011752 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0101892 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 59277 . This is a "QUALCHOICE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com