1043443328 NPI number — SANCHEZ CHIROPRACTIC CENTER, P.C.

Table of content: LAILA NAHAS (NPI 1366282824)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043443328 NPI number — SANCHEZ CHIROPRACTIC CENTER, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SANCHEZ CHIROPRACTIC CENTER, P.C.
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:
1043443328
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/02/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 366
Provider Second Line Business Mailing Address:
2009 CONSTITUTION DRIVE
Provider Business Mailing Address City Name:
IUKA
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
38852-0366
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
662-423-9315
Provider Business Mailing Address Fax Number:
662-423-9359

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2009 CONSTITUTION DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IUKA
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
38852-8457
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-423-9315
Provider Business Practice Location Address Fax Number:
662-423-9359
Provider Enumeration Date:
09/02/2009

Additional Information

Authorized Official

Authorized Official Last Name:
SANCHEZ
Authorized Official First Name:
KIMBERLY
Authorized Official Middle Name:
N
Authorized Official Title or Position:
DR.
Authorized Official Telephone Number:
662-423-9315

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  1054 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00116414 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 03422363 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 03105570 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".




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