1467655357 NPI number — APMJ INC MEDICALL MOBILE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467655357 NPI number — APMJ INC MEDICALL MOBILE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
APMJ INC MEDICALL MOBILE
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:
1467655357
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 173248
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76003-3248
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-477-0942
Provider Business Mailing Address Fax Number:
817-477-4967

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4201 E LOOP 820 S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT WORTH
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76119-4443
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-507-0185
Provider Business Practice Location Address Fax Number:
817-507-2190
Provider Enumeration Date:
06/07/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
JORDAN
Authorized Official First Name:
KENNETH
Authorized Official Middle Name:
MICHAEL
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
817-477-0942

Provider Taxonomy Codes

  • Taxonomy code: 2471C3402X , with the licence number:  208253 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2471V0105X , with the licence number: 104856 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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