1982728242 NPI number — HOFFMAN CHIROPRACTIC CENTER, PC

Table of content: (NPI 1982728242)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982728242 NPI number — HOFFMAN CHIROPRACTIC CENTER, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOFFMAN CHIROPRACTIC CENTER, PC
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:
1982728242
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3864 MEXICO RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT CHARLES
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63303-3041
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:
636-477-8012

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3864 MEXICO RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT CHARLES
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63303-3041
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
636-477-8818
Provider Business Practice Location Address Fax Number:
636-477-8012
Provider Enumeration Date:
03/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HOFFMAN
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
FREDERICK
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
636-477-8818

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  005025 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0004637868 . This is a "AETNA PROVIDER ID" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 177348 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: P00074843 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 119319 . This is a "HEALTHLINK PROVIDER ID" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 125771 . This is a "HEALTHPARTNERS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 167305 . This is a "GROUP HEALTH PLAN" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com