1366901696 NPI number — SIGNAL BUSINESS ADMINISTRATION INC

Table of content: (NPI 1366901696)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366901696 NPI number — SIGNAL BUSINESS ADMINISTRATION INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SIGNAL BUSINESS ADMINISTRATION 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:
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:
1366901696
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/29/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 17460
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDIANAPOLIS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46217-0460
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
765-238-1381
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
135 JORDAN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46217-4003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-260-6145
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/16/2019

Additional Information

Authorized Official

Authorized Official Last Name:
MARCH
Authorized Official First Name:
HAHN
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
765-238-1381

Provider Taxonomy Codes

  • Taxonomy code: 207QA0505X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 201709221215524 . This is a "FAMILY PRACTICE GROUP" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




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