1134235229 NPI number — AIKEN FAMILY PHYSICIANS PC

Table of content: SABRINA KAY HOWELL LPC (NPI 1912923780)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134235229 NPI number — AIKEN FAMILY PHYSICIANS PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AIKEN FAMILY PHYSICIANS PC
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:
1134235229
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
60 PHYSICIAN DR
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
AIKEN
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29801-6388
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-502-0502
Provider Business Mailing Address Fax Number:
803-502-0588

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
60 PHYSICIAN DR
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
AIKEN
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29801-6388
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-502-0502
Provider Business Practice Location Address Fax Number:
803-502-0588
Provider Enumeration Date:
08/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BAXLEY
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
B
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
803-643-2752

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  8997 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: GP4609 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




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