1083043145 NPI number — RAYTEL CARDIAC SERVICES INC

Table of content: (NPI 1083043145)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083043145 NPI number — RAYTEL CARDIAC SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAYTEL CARDIAC SERVICES 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:
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:
1083043145
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/18/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19387 US HIGHWAY 19 N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEARWATER
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33764-3102
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-431-8462
Provider Business Mailing Address Fax Number:
877-524-9504

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
535 ROUTE 38
Provider Second Line Business Practice Location Address:
SUITE 500
Provider Business Practice Location Address City Name:
CHERRY HILL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08002-2953
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-242-7137
Provider Business Practice Location Address Fax Number:
800-742-4582
Provider Enumeration Date:
11/08/2013

Additional Information

Authorized Official

Authorized Official Last Name:
NANNIE
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
Authorized Official Title or Position:
AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
727-530-7700

Provider Taxonomy Codes

  • Taxonomy code: 225400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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