1306237730 NPI number — CHOH TREATMENT AND RECOVERY INC

Table of content: DR. THOMAS GEORGE INMAN JR. DDS (NPI 1881221729)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306237730 NPI number — CHOH TREATMENT AND RECOVERY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHOH TREATMENT AND RECOVERY INC
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:
1306237730
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/09/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
931 VILLAGE BLVD STE 905-358
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST PALM BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33409-1803
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
907 N DIXIE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST PALM BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33401-3329
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-945-2330
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/06/2015

Additional Information

Authorized Official

Authorized Official Last Name:
GROGAN
Authorized Official First Name:
TROY
Authorized Official Middle Name:
JAMES
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
561-945-2330

Provider Taxonomy Codes

  • Taxonomy code: 324500000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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