1326081654 NPI number — UNITED SURGICAL ASSISTANTS NA INC

Table of content: MS. SARA GRACE RICHTER P.T. (NPI 1437452562)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326081654 NPI number — UNITED SURGICAL ASSISTANTS NA INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITED SURGICAL ASSISTANTS NA 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:
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:
1326081654
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/26/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 21724
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33622-1724
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-872-5788
Provider Business Mailing Address Fax Number:
866-698-7272

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12880 COMMODITY PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33626-3101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-872-5788
Provider Business Practice Location Address Fax Number:
866-462-7445
Provider Enumeration Date:
06/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TULLY
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
ANSON
Authorized Official Title or Position:
PRESIDENT, CEO
Authorized Official Telephone Number:
877-872-5788

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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