1487746186 NPI number — RINALDINI MEDICAL PRACTICE

Table of content: (NPI 1487746186)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487746186 NPI number — RINALDINI MEDICAL PRACTICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RINALDINI MEDICAL PRACTICE
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:
1487746186
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/12/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2300 CONCRETE RD
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
CARLISLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40311-9721
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-289-2212
Provider Business Mailing Address Fax Number:
859-289-4744

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 CONCRETE RD
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
CARLISLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40311-9721
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-289-2212
Provider Business Practice Location Address Fax Number:
859-289-4744
Provider Enumeration Date:
09/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RINALDINI
Authorized Official First Name:
ANA
Authorized Official Middle Name:
MARIA
Authorized Official Title or Position:
MD
Authorized Official Telephone Number:
859-289-2212

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  32773 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 64327737 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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