1093891665 NPI number — BARR-THORN ENTERPRISES, 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 1093891665 NPI number — BARR-THORN ENTERPRISES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BARR-THORN ENTERPRISES, 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:
1093891665
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2048
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRUNDY
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24614-2048
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
276-935-4777
Provider Business Mailing Address Fax Number:
276-935-2269

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1330 S MAYO TRL STE 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PIKEVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41501-2321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-432-2274
Provider Business Practice Location Address Fax Number:
606-433-9816
Provider Enumeration Date:
10/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
THORNBURY
Authorized Official First Name:
JOEL
Authorized Official Middle Name:
C
Authorized Official Title or Position:
PIC/VP
Authorized Official Telephone Number:
606-432-6959

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  9101535 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X , with the licence number: 90003021 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X , with the licence number: 1145660002 ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X , with the licence number: 02140000551 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X , with the licence number: P06583 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000239278 . This is a "BLUE CROSS/BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 842863 . This is a "ASSOC. OF DIABETES CARE & EDUCATION SERVICES (ADCES)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9101535 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: P06583 . This is a "STATE LIC" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 90003021 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 149093800 . This is a "DEPT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1826544 . This is a "NCPDP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 54001151 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 08500509 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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