1659316420 NPI number — UNIFORMS UNLTD

Table of content: (NPI 1659316420)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659316420 NPI number — UNIFORMS UNLTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIFORMS UNLTD
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:
1659316420
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8183 ELLSWORTH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELLSWORTH
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49729-9686
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
231-237-9605
Provider Business Mailing Address Fax Number:
231-588-6316

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8183 ELLSWORTH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELLSWORTH
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49729-9686
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
231-237-9605
Provider Business Practice Location Address Fax Number:
231-588-6316
Provider Enumeration Date:
06/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CEBULSKI
Authorized Official First Name:
CYNTHIA
Authorized Official Middle Name:
L
Authorized Official Title or Position:
DME PROVIDER
Authorized Official Telephone Number:
231-237-9605

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 4714791 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 540A51060 . This is a "BCBS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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