1588767578 NPI number — NATIONAL PARK SERVICE

Table of content: (NPI 1588767578)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588767578 NPI number — NATIONAL PARK SERVICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONAL PARK SERVICE
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:
1588767578
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13461 SUNRISE VALLEY DR STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HERNDON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20171-3283
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
833-469-7789
Provider Business Mailing Address Fax Number:
952-985-5671

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 CLINIC RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRAND CANYON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86023-0129
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-638-7792
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HUNTER
Authorized Official First Name:
CHAD
Authorized Official Middle Name:
Authorized Official Title or Position:
BRANCH CHIEF OF EMERGENCY SERVICES
Authorized Official Telephone Number:
928-638-7792

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  NOT REQUIRED ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 853376 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".




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