1619064383 NPI number — HARRIS CHIROPRACTIC 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 1619064383 NPI number — HARRIS CHIROPRACTIC INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARRIS CHIROPRACTIC 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:
DAVIS CHIROPRACTIC
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:
1619064383
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/22/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6430 US ROUTE 60 E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BARBOURSVILLE
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25504-1240
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-736-4111
Provider Business Mailing Address Fax Number:
304-736-0334

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6430 US ROUTE 60 E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BARBOURSVILLE
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25504-1240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-736-4111
Provider Business Practice Location Address Fax Number:
304-736-0334
Provider Enumeration Date:
10/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ADKINS
Authorized Official First Name:
KRISTYN
Authorized Official Middle Name:
D
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
304-736-4111

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 001711097 . This is a "BCBS GROUP ID NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0201267000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com