1275876385 NPI number — VIAQUEST HOLDINGS LTD

Table of content: (NPI 1275876385)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275876385 NPI number — VIAQUEST HOLDINGS LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VIAQUEST HOLDINGS LTD
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:
INSIGHTS
Provider Other Organization Name Type Code:
3
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:
1275876385
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/01/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
525 METRO PL N STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DUBLIN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43017-5320
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-396-0683
Provider Business Mailing Address Fax Number:
317-396-0687

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7830 JOHNSON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46250-2075
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-396-0683
Provider Business Practice Location Address Fax Number:
317-396-0687
Provider Enumeration Date:
03/27/2013

Additional Information

Authorized Official

Authorized Official Last Name:
HARTMAN
Authorized Official First Name:
KELLY
Authorized Official Middle Name:
E
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
317-396-0683

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251S00000X , with the licence number: 200094230-A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 201204250A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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