1144706540 NPI number — MISS MARQUITA CHRISHAY SANDERS M.ED

Table of content: MISS MARQUITA CHRISHAY SANDERS M.ED (NPI 1144706540)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144706540 NPI number — MISS MARQUITA CHRISHAY SANDERS M.ED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANDERS
Provider First Name:
MARQUITA
Provider Middle Name:
CHRISHAY
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
M.ED
Provider Gender Code:
F

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:
1144706540
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/18/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
881 BOYD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHORTER
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36075-4027
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-296-1645
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6200 BRADLEY PARK DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31904-3078
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-221-2024
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/18/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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