1124180443 NPI number — AJINOMOTO CAMBROOKE, INC.

Table of content: (NPI 1437745833)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124180443 NPI number — AJINOMOTO CAMBROOKE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AJINOMOTO CAMBROOKE, 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:
1124180443
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/10/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4 COPELAND DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AYER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01432-1751
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-862-1905
Provider Business Mailing Address Fax Number:
508-416-0067

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 COPELAND DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AYER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01432-1751
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-862-1905
Provider Business Practice Location Address Fax Number:
508-416-0067
Provider Enumeration Date:
12/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RICHARD
Authorized Official First Name:
PAULA
Authorized Official Middle Name:
Authorized Official Title or Position:
TREASURER
Authorized Official Telephone Number:
978-862-1902

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X , with the licence number: MA-7335 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335G00000X , with the licence number: MA-7335 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 10052249 . This is a "CDPHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 70020000ZAR052 . This is a "BCBS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: A2559180 . This is a "OXFORD HEALTH PLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: MB0033 . This is a "HEALTH NET OF NJ" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 91001158700 . This is a "AMERICHOICE OF NJ" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 84199 . This is a "HEALTH PARTNERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2538703 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 103968 . This is a "UCARE OF MN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 000000022076 . This is a "BMC HEALTH NET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 00588237002 . This is a "BCBS OF WESTERN NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 36844 . This is a "MVP HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 704879 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 694981 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 8290130 . This is a "MEDICA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 919669200 . This is a "MN HEALTHCARE PROGRAMS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 95Z042019MA01 . This is a "ANTHEM BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 016352400 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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