1992777411 NPI number — HAMMER INCORPORATED

Table of content: (NPI 1992777411)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992777411 NPI number — HAMMER INCORPORATED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAMMER INCORPORATED
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:
6
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:
1992777411
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/14/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1801 2ND AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DES MOINES
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50314-3606
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-243-2886
Provider Business Mailing Address Fax Number:
515-243-2522

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
113 HIGH AVE E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OSKALOOSA
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52577-2831
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
641-672-2501
Provider Business Practice Location Address Fax Number:
641-672-1510
Provider Enumeration Date:
02/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FLATT
Authorized Official First Name:
TERRY
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
C.E.O.
Authorized Official Telephone Number:
515-243-2886

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 4037242 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 59252 . This is a "WELLMARK PROVIDER NUMBER" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




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