1366467110 NPI number — HEALTH PROFESSIONAL CORPORATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366467110 NPI number — HEALTH PROFESSIONAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH PROFESSIONAL CORPORATION
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:
1366467110
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/25/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
KULOT DE ROSA DR., CHALAN KIYA
Provider Second Line Business Mailing Address:
POB 502878
Provider Business Mailing Address City Name:
SAIPAN
Provider Business Mailing Address State Name:
MP
Provider Business Mailing Address Postal Code:
96950
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
670-234-2901
Provider Business Mailing Address Fax Number:
670-234-2906

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
KULOT DE ROSA DR., CHALAN KIYA
Provider Second Line Business Practice Location Address:
POB 502878
Provider Business Practice Location Address City Name:
SAIPAN
Provider Business Practice Location Address State Name:
MP
Provider Business Practice Location Address Postal Code:
96950
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
670-234-2901
Provider Business Practice Location Address Fax Number:
670-234-2906
Provider Enumeration Date:
07/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ALDAN
Authorized Official First Name:
VICENTE
Authorized Official Middle Name:
SABLAN
Authorized Official Title or Position:
PRESIDENT/DIRECTOR
Authorized Official Telephone Number:
670-234-2901

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X , with the licence number:  777 0001 1 , registered in the state of MP ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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