1366681777 NPI number — ROSEMAN UNIVERSITY OF HEALTH SCIENCES

Table of content: (NPI 1366681777)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366681777 NPI number — ROSEMAN UNIVERSITY OF HEALTH SCIENCES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROSEMAN UNIVERSITY OF HEALTH SCIENCES
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:
1366681777
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/14/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
02/12/2021
NPI Reactivation Date:
04/14/2021

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11 SUNSET WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HENDERSON
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89014-2333
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-968-2019
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 SUNSET WAY
Provider Second Line Business Practice Location Address:
BLDG. C
Provider Business Practice Location Address City Name:
HENDERSON
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89014-2015
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-968-5222
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/09/2009

Additional Information

Authorized Official

Authorized Official Last Name:
COFFMAN
Authorized Official First Name:
RENEE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
702-968-2019

Provider Taxonomy Codes

  • Taxonomy code: 251300000X , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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