1285802074 NPI number — HART & ASSOCIATES

Table of content: (NPI 1285802074)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285802074 NPI number — HART & ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HART & ASSOCIATES
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:
1285802074
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 328
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND BAY
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36541
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-865-4784
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13750 HWY 90
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRAND BAY
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36541
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-865-4784
Provider Business Practice Location Address Fax Number:
251-865-3610
Provider Enumeration Date:
02/14/2008

Additional Information

Authorized Official

Authorized Official Last Name:
HART
Authorized Official First Name:
MARLENE
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
251-865-4784

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  659 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332S00000X , with the licence number: 659 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 659 . This is a "ALA BOARD MEDICAL SERVICE" identifier . This identifiers is of the category "OTHER".




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