1366563397 NPI number — ALTERNATIVE NURSING SERVICES, INC.

Table of content: (NPI 1366563397)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366563397 NPI number — ALTERNATIVE NURSING SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALTERNATIVE NURSING SERVICES, 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:
ANS
Provider Other Organization Name Type Code:
5
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:
1366563397
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:
1827 8TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEWISTON
Provider Business Mailing Address State Name:
ID
Provider Business Mailing Address Postal Code:
83501-3891
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
208-746-3050
Provider Business Mailing Address Fax Number:
208-746-3640

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1827 8TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISTON
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83501-3891
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-746-3050
Provider Business Practice Location Address Fax Number:
208-746-3640
Provider Enumeration Date:
04/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BEIER
Authorized Official First Name:
BRANDEN
Authorized Official Middle Name:
RAFAEL
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
208-746-3050

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X , with the licence number:  2ALTNURSE051 , registered in the state of ID ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 251E00000X , with the licence number: IS218 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 343900000X , with the licence number: 2ALTNURSE051 , registered in the state of ID ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 0027902 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: 042414 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8054618 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8072218 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8050088 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8069168 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0027903 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9043217 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8043067 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8063364 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0027901 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: 129765 . This is a "WASSH. L & I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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