1114040813 NPI number — MEMORIAL BILLING COMPANY

Table of content: MS. MICHELLE CATHERINE NEARY LCSW (NPI 1679734073)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114040813 NPI number — MEMORIAL BILLING COMPANY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEMORIAL BILLING COMPANY
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:
1114040813
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/01/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1480 N M 52
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OWOSSO
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48867-1235
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-723-5211
Provider Business Mailing Address Fax Number:
989-723-9446

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1480 N M52
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OWOSSO
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48867
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-723-5211
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/09/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BREMER
Authorized Official First Name:
JOYCE
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER CODING & PATIENT ACCOUNTS
Authorized Official Telephone Number:
989-729-4528

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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