1437393691 NPI number — ALL MEDICAL INC

Table of content: (NPI 1437393691)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437393691 NPI number — ALL MEDICAL INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALL 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:
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:
1437393691
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/06/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1296
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29202-1296
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-779-2011
Provider Business Mailing Address Fax Number:
803-779-4678

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12445 E 39TH AVE
Provider Second Line Business Practice Location Address:
213
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80239-3462
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-374-7351
Provider Business Practice Location Address Fax Number:
303-574-3325
Provider Enumeration Date:
04/30/2009

Additional Information

Authorized Official

Authorized Official Last Name:
HAYES
Authorized Official First Name:
CHAD
Authorized Official Middle Name:
E
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
720-374-7351

Provider Taxonomy Codes

  • Taxonomy code: 251J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BC3200X , with the licence number: 332B00000X , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 59024861 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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