1437259785 NPI number — MIRACLE MAKING MINISTRIES, INC.

Table of content: (NPI 1437259785)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437259785 NPI number — MIRACLE MAKING MINISTRIES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MIRACLE MAKING MINISTRIES, 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:
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:
1437259785
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:
PO BOX 10044
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUGUSTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30903-2644
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
706-722-8693
Provider Business Mailing Address Fax Number:
706-722-8695

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1127 DRUID PARK AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUGUSTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30904-5849
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-722-8693
Provider Business Practice Location Address Fax Number:
706-722-8695
Provider Enumeration Date:
09/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WILLIAMS
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
L
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
706-722-8693

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X ; 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