1558611145 NPI number — DIAGNOSTIC PLUS LLC

Table of content: (NPI 1558611145)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558611145 NPI number — DIAGNOSTIC PLUS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DIAGNOSTIC PLUS LLC
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:
1558611145
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/12/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 383
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GADSDEN
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35902-0383
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-543-5249
Provider Business Mailing Address Fax Number:
205-874-8333

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 SOUTH 3RD STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GADSDEN
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35901-5304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-543-5249
Provider Business Practice Location Address Fax Number:
205-874-8333
Provider Enumeration Date:
09/12/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ZHANG
Authorized Official First Name:
LIPING
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/PHYSICIAN
Authorized Official Telephone Number:
310-869-4253

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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