1184616641 NPI number — RONALD J. FARABAUGH DC, INC.

Table of content: (NPI 1184616641)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184616641 NPI number — RONALD J. FARABAUGH DC, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RONALD J. FARABAUGH DC, 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:
FARABAUGH CHIROPRACTIC OFFICE
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:
1184616641
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/19/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2879 E DUBLIN GRANVILLE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43231-4063
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-898-0787
Provider Business Mailing Address Fax Number:
614-898-1945

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2879 E DUBLIN GRANVILLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43231-4063
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-898-0787
Provider Business Practice Location Address Fax Number:
614-898-1945
Provider Enumeration Date:
08/19/2005

Additional Information

Authorized Official

Authorized Official Last Name:
FARABAUGH
Authorized Official First Name:
RONALD
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
614-898-0787

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  939 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 111N00000X , with the licence number: 1746 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 111N00000X , with the licence number: 3799 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 28676858700 . This is a "BWC" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0861090 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1746 . This is a "LICENSE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 29774467900 . This is a "BWC" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 939 . This is a "LICENSE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: RO9300211 . This is a "MEDICARE GROUP #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 3799 . This is a "LICENSE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0496922 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 17750858200 . This is a "BWC" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2117024 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com