1598097222 NPI number — TARPON SPRINGS HOSPITAL FOUNDATION INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598097222 NPI number — TARPON SPRINGS HOSPITAL FOUNDATION INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TARPON SPRINGS HOSPITAL FOUNDATION 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:
HELEN ELLIS MEMORIAL HOSPITAL PHYSICIANS GROUP
Provider Other Organization Name Type Code:
3
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:
1598097222
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/04/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1501 ALTERNATE 19 SOUTH
Provider Second Line Business Mailing Address:
SUITE J
Provider Business Mailing Address City Name:
TARPON SPRINGS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34689-3790
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-943-3642
Provider Business Mailing Address Fax Number:
727-942-9745

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1501 ALTERNATE 19 SOUTH
Provider Second Line Business Practice Location Address:
SUITE J
Provider Business Practice Location Address City Name:
TARPON SPRINGS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34689-3790
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-943-3642
Provider Business Practice Location Address Fax Number:
727-942-9745
Provider Enumeration Date:
02/05/2010

Additional Information

Authorized Official

Authorized Official Last Name:
HEINRICH
Authorized Official First Name:
CALEB
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
727-942-5107

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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