1427477207 NPI number — WELLINGTON INSTITUTE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427477207 NPI number — WELLINGTON INSTITUTE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WELLINGTON INSTITUTE, 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:
1427477207
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/09/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
227 ROUSER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RIDGELAND
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39157-5060
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
601-853-3688
Provider Business Mailing Address Fax Number:
601-321-9849

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5360 EXECUTIVE PL
Provider Second Line Business Practice Location Address:
BUILDING C
Provider Business Practice Location Address City Name:
JACKSON
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39206-4101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-321-9849
Provider Business Practice Location Address Fax Number:
601-321-9849
Provider Enumeration Date:
04/09/2014

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
GLADYS
Authorized Official Middle Name:
DINKINS
Authorized Official Title or Position:
PRESIDNT
Authorized Official Telephone Number:
601-720-1671

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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