1134349350 NPI number — MEDPLUS MGT.CLINIC INC

Table of content: (NPI 1134349350)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134349350 NPI number — MEDPLUS MGT.CLINIC INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDPLUS MGT.CLINIC 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:
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:
1134349350
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
279-E RODRIGUEZ AVENUE
Provider Second Line Business Mailing Address:
SUITE 715 NORTH TOWER CATHEDRAL HTS BLDG ST.LUKES MED
Provider Business Mailing Address City Name:
QUEZON CITY
Provider Business Mailing Address State Name:
MANILA
Provider Business Mailing Address Postal Code:
1102
Provider Business Mailing Address Country Code:
PH
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
279-E RODRIGUEZ AVENUE
Provider Second Line Business Practice Location Address:
SUITE 715 NORTH TOWER CATHEDRAL HTS BLDG ST.LUKES MED
Provider Business Practice Location Address City Name:
QUEZON CITY
Provider Business Practice Location Address State Name:
MANILA
Provider Business Practice Location Address Postal Code:
1102
Provider Business Practice Location Address Country Code:
PH
Provider Business Practice Location Address Telephone Number:
06327230101
Provider Business Practice Location Address Fax Number:
028098642
Provider Enumeration Date:
04/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FERNANDEZ
Authorized Official First Name:
RACHEL
Authorized Official Middle Name:
RAMOS
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
63-723-0101

Provider Taxonomy Codes

  • Taxonomy code: 305R00000X , with the licence number:  0293847162 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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