1538395249 NPI number — ROCHE INSULIN DELIVERY SYSTEMS INC.

Table of content: (NPI 1538395249)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538395249 NPI number — ROCHE INSULIN DELIVERY SYSTEMS INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROCHE INSULIN DELIVERY SYSTEMS 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:
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:
1538395249
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/31/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11800 EXIT 5 PKWY
Provider Second Line Business Mailing Address:
SUITE 120
Provider Business Mailing Address City Name:
FISHERS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46037-7988
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-280-7801
Provider Business Mailing Address Fax Number:
317-570-5300

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2820 COLUMBIANA RD
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35216-2589
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-280-7801
Provider Business Practice Location Address Fax Number:
317-570-5300
Provider Enumeration Date:
06/09/2009

Additional Information

Authorized Official

Authorized Official Last Name:
SAMS
Authorized Official First Name:
HOWARD
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR, BUSINESS OPERATIONS
Authorized Official Telephone Number:
317-521-0108

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  69000283A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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