1336519834 NPI number — KEY SEATING & MOBILITY, LLC

Table of content: DR. STEPHEN L. STOOPS M.D. (NPI 1427158906)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336519834 NPI number — KEY SEATING & MOBILITY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KEY SEATING & MOBILITY, LLC
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:
1336519834
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/09/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2016 E PERKINS AVE
Provider Second Line Business Mailing Address:
SUITE D
Provider Business Mailing Address City Name:
SANDUSKY
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44870-5129
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-202-2462
Provider Business Mailing Address Fax Number:
866-443-6788

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2016 E PERKINS AVE STE D
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANDUSKY
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44870-5129
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-357-6060
Provider Business Practice Location Address Fax Number:
866-443-6788
Provider Enumeration Date:
09/28/2015

Additional Information

Authorized Official

Authorized Official Last Name:
KIEPERT
Authorized Official First Name:
SEAN
Authorized Official Middle Name:
ROBERT
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
419-357-6060

Provider Taxonomy Codes

  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0145067 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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