1134476997 NPI number — QASSIM UNIVERSITY

Table of content: (NPI 1134476997)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134476997 NPI number — QASSIM UNIVERSITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
QASSIM UNIVERSITY
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:
1134476997
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/12/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
QASSIM UNIVERSITY COLLEGE OF MEDICINE, DEPT OF FAMILY/
Provider Second Line Business Mailing Address:
COMMUNITY MED, ROOM 3061
Provider Business Mailing Address City Name:
MULAIDAH
Provider Business Mailing Address State Name:
ALQASSIM
Provider Business Mailing Address Postal Code:
51442
Provider Business Mailing Address Country Code:
SA
Provider Business Mailing Address Telephone Number:
0096663800050
Provider Business Mailing Address Fax Number:
00966638000502076

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
QASSIM UNIVERSITY, DEPT OF FAMILY MEDICINE
Provider Second Line Business Practice Location Address:
ROOM 3061
Provider Business Practice Location Address City Name:
MULAIDAH
Provider Business Practice Location Address State Name:
ALQASSIM
Provider Business Practice Location Address Postal Code:
51442
Provider Business Practice Location Address Country Code:
SA
Provider Business Practice Location Address Telephone Number:
0096663800050
Provider Business Practice Location Address Fax Number:
00966638000502076
Provider Enumeration Date:
08/12/2012

Additional Information

Authorized Official

Authorized Official Last Name:
AL-MOHAIMEED
Authorized Official First Name:
ABDULRAHMAN
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE DEAN QUALITY & DEVELOPMENT
Authorized Official Telephone Number:
0096663800050

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  30988-S , registered in the state of ZZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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