1487635645 NPI number — ADT SECURITY SERVICES, INC.

Table of content: (NPI 1487635645)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487635645 NPI number — ADT SECURITY SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADT SECURITY SERVICES, 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:
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:
1487635645
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:
32100 US HIGHWAY 19 N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PALM HARBOR
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34684-3709
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-786-5781
Provider Business Mailing Address Fax Number:
877-666-4390

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
32100 US HIGHWAY 19 N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PALM HARBOR
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34684-3709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-786-5781
Provider Business Practice Location Address Fax Number:
877-666-4390
Provider Enumeration Date:
11/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
LANE
Authorized Official First Name:
ALISON
Authorized Official Middle Name:
Authorized Official Title or Position:
TEAM MANAGER, CONSOLIDATED BILLING
Authorized Official Telephone Number:
727-786-5781

Provider Taxonomy Codes

  • Taxonomy code: 146D00000X , with the licence number:  EF 000 1123 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0588871 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0017352320002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3409417 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0445793 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0135740 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1787418 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8587308801 , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 012258000 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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