1366500944 NPI number — CORFMAN CHIROPRACTIC GROUP P.C.

Table of content: (NPI 1366500944)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366500944 NPI number — CORFMAN CHIROPRACTIC GROUP P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CORFMAN CHIROPRACTIC GROUP P.C.
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:
1366500944
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2134 HELTON DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLORENCE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35630-1449
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-767-7230
Provider Business Mailing Address Fax Number:
256-767-7267

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2134 HELTON DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLORENCE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35630-1449
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-767-7230
Provider Business Practice Location Address Fax Number:
256-767-7267
Provider Enumeration Date:
12/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CORFMAN
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
HOWARD
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
256-767-7230

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  1639 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 51003159 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: P00284783 . This is a "MEDICARE RAILROAD CARRIER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5470134 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4128246 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 4265074 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".




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