1477898468 NPI number — RALEIGH NEUROLOGY ASSOCIATES PA

Table of content: JENNIFER DARLENE COGAR RN (NPI 1427728708)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477898468 NPI number — RALEIGH NEUROLOGY ASSOCIATES PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RALEIGH NEUROLOGY 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:
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:
1477898468
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/28/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1540 SUNDAY DR
Provider Second Line Business Mailing Address:
FIRST FLOOR
Provider Business Mailing Address City Name:
RALEIGH
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27607-6010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-325-4275
Provider Business Mailing Address Fax Number:
919-325-4684

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1540 SUNDAY DR
Provider Second Line Business Practice Location Address:
FIRST FLOOR
Provider Business Practice Location Address City Name:
RALEIGH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27607-6010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-325-4275
Provider Business Practice Location Address Fax Number:
919-325-4684
Provider Enumeration Date:
12/03/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CHAPMAN
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
PHARMACIST/PHCY OPS MGR
Authorized Official Telephone Number:
919-325-4275

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0004X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 11432 , 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: 2138040 . This is a "PK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0920775 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".