1255834503 NPI number — PULSE MEDICAL STAFFING

Table of content: (NPI 1255834503)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255834503 NPI number — PULSE MEDICAL STAFFING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PULSE MEDICAL STAFFING
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:
1255834503
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/11/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
620 N TRADEWINDS PKWY STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65201-7239
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-883-8677
Provider Business Mailing Address Fax Number:
877-883-8677

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
620 N TRADEWINDS PKWY STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65201-7239
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-883-8677
Provider Business Practice Location Address Fax Number:
877-883-8677
Provider Enumeration Date:
03/13/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LATHAM
Authorized Official First Name:
DANNY
Authorized Official Middle Name:
JOE
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
877-883-8677

Provider Taxonomy Codes

  • Taxonomy code: 163WH0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 164W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251F00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3747A0650X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3747P1801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 374U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 376J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 376K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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