1053677542 NPI number — AMR MEDICAL CORPORATION

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 1053677542 NPI number — AMR MEDICAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMR MEDICAL CORPORATION
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:
1053677542
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/09/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1255 W SHAW AVE
Provider Second Line Business Mailing Address:
STE # 104
Provider Business Mailing Address City Name:
FRESNO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93711-3716
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-225-2797
Provider Business Mailing Address Fax Number:
559-225-2752

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1255 W SHAW AVE
Provider Second Line Business Practice Location Address:
STE # 104
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93711-3716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-225-2797
Provider Business Practice Location Address Fax Number:
559-225-2752
Provider Enumeration Date:
04/09/2012

Additional Information

Authorized Official

Authorized Official Last Name:
BURNETT
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
F
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
559-225-2797

Provider Taxonomy Codes

  • Taxonomy code: 208200000X , with the licence number:  G45980 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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