1598728198 NPI number — MR. RAYMOND JOHN STRUTH JR. RD, LDN

Table of content: MR. RAYMOND JOHN STRUTH JR. RD, LDN (NPI 1598728198)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598728198 NPI number — MR. RAYMOND JOHN STRUTH JR. RD, LDN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STRUTH
Provider First Name:
RAYMOND
Provider Middle Name:
JOHN
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
RD, LDN
Provider Gender Code:
M

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:
1598728198
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/17/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1130 NEW CASTLE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28803-2163
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-337-3093
Provider Business Mailing Address Fax Number:
828-299-5988

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 TUNNEL RD
Provider Second Line Business Practice Location Address:
NUTRITION & FOOD SERVICES
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28805-2043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-298-7911
Provider Business Practice Location Address Fax Number:
828-299-5988
Provider Enumeration Date:
04/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X , with the licence number:  L002882 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 133V00000X , with the licence number: R526808 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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