1427032291 NPI number — ADVOCATE MEDICAL SERVICES, LLC

Table of content: (NPI 1427032291)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427032291 NPI number — ADVOCATE MEDICAL SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVOCATE MEDICAL SERVICES, LLC
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:
1427032291
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/09/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1701 BROADWAY ST NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55413-2638
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-651-6223
Provider Business Mailing Address Fax Number:
866-896-7171

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5912 BRECKENRIDGE PKWY STE G
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33610-4200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-280-6543
Provider Business Practice Location Address Fax Number:
877-426-7329
Provider Enumeration Date:
12/05/2005

Additional Information

Authorized Official

Authorized Official Last Name:
GRIGGS
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
407-206-0040

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  1312723 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 200492890 A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1427032291 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1513981 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1427032291 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8872554 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: DE2783 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001696900 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100119020 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7705170 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 877946 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 009961215 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1427032291 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1427032291 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2357336 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3590001 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 572140235A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1730511965 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 20708006001 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 20708006001 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2502901 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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