1649308818 NPI number — GETTY INC.

Table of content: (NPI 1649308818)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649308818 NPI number — GETTY INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GETTY 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:
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:
1649308818
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/02/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21850 TALL TIMBERS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NISSWA
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56468-2367
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
218-963-8899
Provider Business Mailing Address Fax Number:
218-963-9573

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14775 EDGEWOOD DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAXTER
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56425-8456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-963-8899
Provider Business Practice Location Address Fax Number:
218-963-9573
Provider Enumeration Date:
03/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GETTY
Authorized Official First Name:
TERRIE
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
218-963-8899

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  334211 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 164797 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 202D5MN . This is a "BLUE CROSS BLUE SHEILD" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 5900230 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 751108600 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".




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