1417232927 NPI number — SEQUENTIAL MANAGEMENT GROUP INC

Table of content: (NPI 1417232927)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417232927 NPI number — SEQUENTIAL MANAGEMENT GROUP INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SEQUENTIAL MANAGEMENT GROUP 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:
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:
1417232927
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/23/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3040 PHARR COURT NORTH NW STE 5
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:
30305
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
866-563-5557
Provider Business Mailing Address Fax Number:
800-665-6727

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3040 PHARR COURT NORTH NW STE 5
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-563-5557
Provider Business Practice Location Address Fax Number:
800-665-6727
Provider Enumeration Date:
10/15/2011

Additional Information

Authorized Official

Authorized Official Last Name:
GARY
Authorized Official First Name:
SEAN
Authorized Official Middle Name:
MICHAEL
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
866-563-5557

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  0569745 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com