1164744116 NPI number — MARGARET A ALLEN OD PA

Table of content: (NPI 1164744116)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164744116 NPI number — MARGARET A ALLEN OD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARGARET A ALLEN OD PA
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:
VAL-UVISION AT BRANAN FIELD
Provider Other Organization Name Type Code:
3
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:
1164744116
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/15/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1545 BRANAN FIELD RD
Provider Second Line Business Mailing Address:
SUITE 5
Provider Business Mailing Address City Name:
MIDDLEBURG
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32068-8428
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-291-5800
Provider Business Mailing Address Fax Number:
904-291-9772

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1545 BRANAN FIELD RD
Provider Second Line Business Practice Location Address:
SUITE 5
Provider Business Practice Location Address City Name:
MIDDLEBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32068-8428
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-291-5800
Provider Business Practice Location Address Fax Number:
904-291-9772
Provider Enumeration Date:
02/18/2010

Additional Information

Authorized Official

Authorized Official Last Name:
ALLEN
Authorized Official First Name:
MARGARET
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
904-291-5800

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  OPC2968 , 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)





Copyright © 2007-2024 www.npivalidator.com