1245937325 NPI number — BILLIONTOONE, INC.

Table of content: (NPI 1245937325)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245937325 NPI number — BILLIONTOONE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BILLIONTOONE, 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:
1245937325
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/06/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8040
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAROL STREAM
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60197-8040
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
616-607-4884
Provider Business Mailing Address Fax Number:
866-243-4198

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1035 OBRIEN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MENLO PARK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94025-1408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
616-607-4884
Provider Business Practice Location Address Fax Number:
866-243-4198
Provider Enumeration Date:
02/09/2023

Additional Information

Authorized Official

Authorized Official Last Name:
WASKIEWICZ
Authorized Official First Name:
MARY
Authorized Official Middle Name:
Authorized Official Title or Position:
LEAD CREDENTIALING AND CONTRACT COO
Authorized Official Telephone Number:
616-607-4884

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0088270 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10026909901 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2302711 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 451074701 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: CA384475 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 05D2275351 . This is a "CLIA CERTIFICATE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1245937325 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 167293 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9000235262 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30015266820005 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 334198709 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4294420 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".




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