1174991061 NPI number — PER MAR SECURITY & RESEARCH CORP

Table of content: (NPI 1174991061)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174991061 NPI number — PER MAR SECURITY & RESEARCH CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PER MAR SECURITY & RESEARCH CORP
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:
1174991061
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/09/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1910 E KIMBERLY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DAVENPORT
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52807-2033
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
563-441-7400
Provider Business Mailing Address Fax Number:
563-355-8736

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4111 TECHNOLOGY DR NW
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
BEMIDJI
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56601-5128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-444-3902
Provider Business Practice Location Address Fax Number:
218-751-7023
Provider Enumeration Date:
09/09/2015

Additional Information

Authorized Official

Authorized Official Last Name:
DUFFY
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
PATRICK
Authorized Official Title or Position:
PRESIDENT OF ELECTRONIC SECURITY
Authorized Official Telephone Number:
563-441-7400

Provider Taxonomy Codes

  • Taxonomy code: 333300000X , with the licence number:  4055 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com