1255359089 NPI number — NATIONAL HEALTH CARE SERVICES LLC

Table of content: (NPI 1255359089)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255359089 NPI number — NATIONAL HEALTH CARE SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONAL HEALTH CARE SERVICES LLC
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:
1255359089
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 53086
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LUBBOCK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79453-3086
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-780-0098
Provider Business Mailing Address Fax Number:
806-780-0207

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8004 INDIANA AVE
Provider Second Line Business Practice Location Address:
STE B3
Provider Business Practice Location Address City Name:
LUBBOCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79423-2036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-780-0098
Provider Business Practice Location Address Fax Number:
806-780-0207
Provider Enumeration Date:
07/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CAIN
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
806-780-0098

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 45075239 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 530582 . This is a "BLUE CROSS BLUE SHIELD TX" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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