1255561478 NPI number — HIERS ENTERPRISES

Table of content: AMY K HULL L.I.S.W. (NPI 1043436264)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255561478 NPI number — HIERS ENTERPRISES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HIERS ENTERPRISES
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:
1255561478
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1350 NE STEPHENS ST
Provider Second Line Business Mailing Address:
SUITE 42
Provider Business Mailing Address City Name:
ROSEBURG
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97470-6418
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-672-8399
Provider Business Mailing Address Fax Number:
541-672-8330

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1350 NE STEPHENS ST
Provider Second Line Business Practice Location Address:
SUITE 42
Provider Business Practice Location Address City Name:
ROSEBURG
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97470-6418
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-672-8399
Provider Business Practice Location Address Fax Number:
541-672-8330
Provider Enumeration Date:
07/22/2009

Additional Information

Authorized Official

Authorized Official Last Name:
HIERS
Authorized Official First Name:
GEORGE
Authorized Official Middle Name:
MARTIN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
541-672-8399

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  RP-0001597-CS , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3813311 . This is a "NABP" identifier . This identifiers is of the category "OTHER".




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