1073625265 NPI number — WEST INC

Table of content: (NPI 1073625265)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073625265 NPI number — WEST INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WEST 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:
MERLE NORMAN COSMETICS
Provider Other Organization Name Type Code:
3
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:
1073625265
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:
2008 MERCHANT DR
Provider Second Line Business Mailing Address:
SUITE 9
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40475-8188
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-624-9825
Provider Business Mailing Address Fax Number:
859-624-8430

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2008 MERCHANT DR
Provider Second Line Business Practice Location Address:
SUITE 9
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40475-8188
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-624-9825
Provider Business Practice Location Address Fax Number:
859-624-8430
Provider Enumeration Date:
08/31/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WEST
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
859-624-9825

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7409653 . This is a "AETNA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000338181 . This is a "ANTHEM BCBS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 90009739 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".