1437426004 NPI number — FREDERICK KIRBY GARRETT TRANSPORTATION

Table of content: FREDERICK KIRBY GARRETT TRANSPORTATION (NPI 1437426004)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437426004 NPI number — FREDERICK KIRBY GARRETT TRANSPORTATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARRETT
Provider First Name:
FREDERICK
Provider Middle Name:
KIRBY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
TRANSPORTATION
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GARRETT
Provider Other First Name:
FREDERICK
Provider Other Middle Name:
KIRBY
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1437426004
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/25/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
142 BAKER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINCHESTER
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22601-5035
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-441-6000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
308 WILSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARTINSBURG
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25401-3022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-441-6000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/25/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 344600000X , with the licence number:  2251-8418 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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