1205125176 NPI number — INTRINSIC INC

Table of content: (NPI 1205125176)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205125176 NPI number — INTRINSIC INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INTRINSIC 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:
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:
1205125176
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/23/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
106 E NORTH ST
Provider Second Line Business Mailing Address:
FL 2, STE 208B
Provider Business Mailing Address City Name:
NEW CASTLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16101-3736
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-656-1667
Provider Business Mailing Address Fax Number:
724-654-6014

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
106 E NORTH ST
Provider Second Line Business Practice Location Address:
FL 2, STE 208B
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16101-3736
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-656-1667
Provider Business Practice Location Address Fax Number:
724-654-1140
Provider Enumeration Date:
03/31/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GEORGE
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
JAMES
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
724-656-1667

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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