1467582999 NPI number — BILTMORE DERMATOLOGY ASSOCIATES PA

Table of content: (NPI 1467582999)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467582999 NPI number — BILTMORE DERMATOLOGY ASSOCIATES PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BILTMORE DERMATOLOGY ASSOCIATES PA
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:
1467582999
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/01/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 392
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SYLVA
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28779-0392
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-467-3381
Provider Business Mailing Address Fax Number:
828-586-8209

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
80 PEACHTREE RD STE 106
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28803-3180
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-232-5222
Provider Business Practice Location Address Fax Number:
828-258-3003
Provider Enumeration Date:
03/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
NURRE
Authorized Official First Name:
LISA
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
828-232-5222

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X , with the licence number:  9501031 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 89012 5 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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