1386068500 NPI number — COMPASS GROUP USA, INC. BY & THROUGH IT BATEMAN DIVISION

Table of content: (NPI 1386068500)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386068500 NPI number — COMPASS GROUP USA, INC. BY & THROUGH IT BATEMAN DIVISION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMPASS GROUP USA, INC. BY & THROUGH IT BATEMAN DIVISION
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:
1386068500
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/07/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5801 PEACHTREE DUNWOODY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30342-1503
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-845-3380
Provider Business Mailing Address Fax Number:
866-846-0685

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
849 F ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95605-2313
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-371-7340
Provider Business Practice Location Address Fax Number:
916-376-0568
Provider Enumeration Date:
02/07/2014

Additional Information

Authorized Official

Authorized Official Last Name:
BRETTLER
Authorized Official First Name:
MAGI
Authorized Official Middle Name:
LOUISE
Authorized Official Title or Position:
REGIONAL VICE PRESIDENT
Authorized Official Telephone Number:
337-319-8850

Provider Taxonomy Codes

  • Taxonomy code: 332U00000X , with the licence number:  13413 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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