1992866438 NPI number — OSTEOPOROSIS TESTING CENTERS INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992866438 NPI number — OSTEOPOROSIS TESTING CENTERS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OSTEOPOROSIS TESTING CENTERS 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:
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:
1992866438
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26206 W 12 MILE ROAD
Provider Second Line Business Mailing Address:
STE 103
Provider Business Mailing Address City Name:
SOUTHFIELD
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48034
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-827-1110
Provider Business Mailing Address Fax Number:
248-827-1119

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26206 W 12 MILE ROAD
Provider Second Line Business Practice Location Address:
STE 103
Provider Business Practice Location Address City Name:
SOUTHFIELD
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-827-1110
Provider Business Practice Location Address Fax Number:
248-827-1119
Provider Enumeration Date:
12/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PLASKO
Authorized Official First Name:
GARY
Authorized Official Middle Name:
Authorized Official Title or Position:
VP
Authorized Official Telephone Number:
248-827-1110

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 110F371520 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".




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