1164542825 NPI number — TOTAL MARKETING TECHNOLOGIES, INC.

Table of content: (NPI 1164542825)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164542825 NPI number — TOTAL MARKETING TECHNOLOGIES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOTAL MARKETING TECHNOLOGIES, 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:
6
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:
1164542825
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/05/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25591 TECHNOLOGY BLVD
Provider Second Line Business Mailing Address:
UNIT B
Provider Business Mailing Address City Name:
PUNTA GORDA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33950-4701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-880-9451
Provider Business Mailing Address Fax Number:
888-558-5748

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25591 TECHNOLOGY BLVD
Provider Second Line Business Practice Location Address:
UNIT B
Provider Business Practice Location Address City Name:
PUNTA GORDA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33950-4701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-880-9451
Provider Business Practice Location Address Fax Number:
888-558-5748
Provider Enumeration Date:
03/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PEAT
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
800-880-9451

Provider Taxonomy Codes

  • Taxonomy code: 347E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416A0800X , with the licence number: 471 , 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)

  • Identifier: 1164542825 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".
  • Identifier: A0478 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 0215058 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 500610425 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5500100200 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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