1437134822 NPI number — DARMSTADT HEALTH CLINIC

Table of content: (NPI 1437134822)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437134822 NPI number — DARMSTADT HEALTH CLINIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DARMSTADT HEALTH CLINIC
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:
1437134822
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
596 CS MAINT CO.
Provider Second Line Business Mailing Address:
CMR 440 BOX 577
Provider Business Mailing Address City Name:
APO, AE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
09175-0577
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-348-6521
Provider Business Mailing Address Fax Number:
314-348-7378

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ATTN; CREDENTIALS OFFICE
Provider Second Line Business Practice Location Address:
CMR 442
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
09042
Provider Business Practice Location Address Country Code:
DE
Provider Business Practice Location Address Telephone Number:
314-348-6521
Provider Business Practice Location Address Fax Number:
314-348-7378
Provider Enumeration Date:
12/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
CABA
Authorized Official First Name:
LOIS JEAN
Authorized Official Middle Name:
ABENOJA
Authorized Official Title or Position:
CLINICAL NURSE
Authorized Official Telephone Number:
314-348-6521

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  RN-46458 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: RN-46458 . This is a "REGISTERED NURSE" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".




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