1427103688 NPI number — ARTEX MEDICAL, INC.

Table of content: (NPI 1427103688)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427103688 NPI number — ARTEX MEDICAL, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARTEX MEDICAL, 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:
1427103688
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/02/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5548
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TEXARKANA
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75505-5548
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-793-0416
Provider Business Mailing Address Fax Number:
903-791-8665

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3101 KENNEDY LN
Provider Second Line Business Practice Location Address:
SUITE 1000
Provider Business Practice Location Address City Name:
TEXARKANA
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75503-2457
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-793-0416
Provider Business Practice Location Address Fax Number:
903-791-8665
Provider Enumeration Date:
01/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
JONES
Authorized Official First Name:
JULIE
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF OPERATIONS
Authorized Official Telephone Number:
903-793-0416

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 137030716 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1694452 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100815060 , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 111325002 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 97822 . This is a "AR BCBS DME NUMBER" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 4A046 . This is a "AR BCBS HIT NUMBER" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 1268101 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 750846 . This is a "TX BCBS HIT NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 017151401 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 350139 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 138761407 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4509886 . This is a "NCPDP PHARMACY NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 530597 . This is a "TX BCBS DME NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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