1225193477 NPI number — IRA H. REX III, M.D., P.C.

Table of content: KAMIE NICOLE JAMES PTA (NPI 1316425812)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225193477 NPI number — IRA H. REX III, M.D., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
IRA H. REX III, M.D., P.C.
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:
1225193477
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/05/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 N MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FALL RIVER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02720-2130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-674-6100
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FALL RIVER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02720-2130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-674-6100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FIELDING-REX
Authorized Official First Name:
ROBIN
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
508-674-6100

Provider Taxonomy Codes

  • Taxonomy code: 208200000X , with the licence number:  76995 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1300065 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 797314 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 204281 . This is a "BLUE CHIP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: M17366 . This is a "BCBS OF MA (GROUP)" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0019396 . This is a "NEIGHBORHOOD HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 21215 . This is a "HARVARD PILGRIM HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 4833-8 . This is a "BCBS OF RI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: J13304 . This is a "BCBS OF MA (INDIVIDUAL)" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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