1669878302 NPI number — JAMES RIVER SENIOR CITIZENS 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 1669878302 NPI number — JAMES RIVER SENIOR CITIZENS INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAMES RIVER SENIOR CITIZENS 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:
1669878302
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/07/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1092
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JAMESTOWN
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58402-1092
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-252-2882
Provider Business Mailing Address Fax Number:
701-252-2529

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
419 5TH ST NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JAMESTOWN
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58401-3318
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-252-2882
Provider Business Practice Location Address Fax Number:
701-252-2529
Provider Enumeration Date:
11/07/2014

Additional Information

Authorized Official

Authorized Official Last Name:
SAHR
Authorized Official First Name:
RHONDA
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
701-252-2882

Provider Taxonomy Codes

  • Taxonomy code: 347B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 053084 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com