1972607182 NPI number — ALL MED LLC

Table of content: (NPI 1972607182)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972607182 NPI number — ALL MED LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALL MED 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:
SABER MEDICAL
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:
1972607182
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/24/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 ST CHRISTOPHER DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHLAND
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-833-0775
Provider Business Mailing Address Fax Number:
606-833-0576

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 ST CHRISTOPHER DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHLAND
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-833-0775
Provider Business Practice Location Address Fax Number:
606-833-0576
Provider Enumeration Date:
09/08/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SABER
Authorized Official First Name:
MARK
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER CEO
Authorized Official Telephone Number:
304-721-0775

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BP3500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 90008459 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0147815000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2231463 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".