1144579509 NPI number — PAR COUNSELING SERVICES, LLC

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 1144579509 NPI number — PAR COUNSELING SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PAR COUNSELING SERVICES, LLC
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:
1144579509
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/31/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7966 HAMPTON LAKE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33647-3661
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-765-2748
Provider Business Mailing Address Fax Number:
813-436-5525

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3632 LAND O LAKES BLVD
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
LAND O LAKES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34639-4405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-765-2748
Provider Business Practice Location Address Fax Number:
813-436-5525
Provider Enumeration Date:
08/31/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MULROY
Authorized Official First Name:
KELLY
Authorized Official Middle Name:
JOHN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
813-765-2748

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  MH9046 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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