1144553447 NPI number — JOHNSON ALLIED SUPPORT SERVICES, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144553447 NPI number — JOHNSON ALLIED SUPPORT SERVICES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOHNSON ALLIED SUPPORT SERVICES, 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:
1144553447
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/17/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3215 GUESS RD
Provider Second Line Business Mailing Address:
SUITE 205
Provider Business Mailing Address City Name:
DURHAM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27705-2665
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-471-9860
Provider Business Mailing Address Fax Number:
919-261-6493

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3215 GUESS RD
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27705-2665
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-471-9860
Provider Business Practice Location Address Fax Number:
919-261-6493
Provider Enumeration Date:
09/17/2009

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
LYNDON
Authorized Official Middle Name:
BYRON
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
919-539-3990

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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