1588989271 NPI number — RESOURCE ONE MEDICAL STAFFING

Table of content: LUIS ANGEL CISNEROS SALGADO (NPI 1528742616)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588989271 NPI number — RESOURCE ONE MEDICAL STAFFING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RESOURCE ONE MEDICAL STAFFING
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:
1588989271
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/06/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1590 BONNIE LN
Provider Second Line Business Mailing Address:
SUITE 103
Provider Business Mailing Address City Name:
CORDOVA
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38016-0506
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-751-7466
Provider Business Mailing Address Fax Number:
901-751-5335

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1590 BONNIE LN
Provider Second Line Business Practice Location Address:
SUITE103
Provider Business Practice Location Address City Name:
CORDOVA
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38016-0506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-751-7466
Provider Business Practice Location Address Fax Number:
901-751-5335
Provider Enumeration Date:
04/06/2010

Additional Information

Authorized Official

Authorized Official Last Name:
HUTCHESON
Authorized Official First Name:
DUANE
Authorized Official Middle Name:
PERRY
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
901-751-7466

Provider Taxonomy Codes

  • Taxonomy code: 251J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: H445330 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com