1568851384 NPI number — E&F FOWLER INC

Table of content: (NPI 1568851384)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568851384 NPI number — E&F FOWLER INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
E&F FOWLER 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:
1568851384
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/16/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
600 MARKET ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HORSESHOE BEND
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72512-3876
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
870-670-4580
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HORSESHOE BEND
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72512-3876
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-670-4580
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/16/2015

Additional Information

Authorized Official

Authorized Official Last Name:
BLAIR
Authorized Official First Name:
JENIFER
Authorized Official Middle Name:
MICHELE
Authorized Official Title or Position:
OFFICE
Authorized Official Telephone Number:
870-670-4580

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  AR20535 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 165787733 . This is a "MEDICAID OLD RX PROVIDER ID" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 49969 . This is a "BCBS" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: E3439 . This is a "EDI SUBMITTER #" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 1427228659 . This is a "BCBS" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: B08007585 . This is a "MEDICARE EDI TRADING PARTNER ID" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 161094407 . This is a "MEDICAID RX PROVIDER ID" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 5F775 . This is a "BCBS" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 162358716 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com