1679320931 NPI number — APPLIED THERAPEUTIC STRATEGIES LLC

Table of content: (NPI 1679320931)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679320931 NPI number — APPLIED THERAPEUTIC STRATEGIES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
APPLIED THERAPEUTIC STRATEGIES LLC
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:
1679320931
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/06/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2099
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KAMUELA
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96743-2099
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-885-5050
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
65-1279 KAWAIHAE RD STE 218
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAMUELA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96743-8444
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-557-6717
Provider Business Practice Location Address Fax Number:
808-887-6717
Provider Enumeration Date:
05/03/2024

Additional Information

Authorized Official

Authorized Official Last Name:
CHELMINIAK
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
JAMES
Authorized Official Title or Position:
THERAPIST / OWNER
Authorized Official Telephone Number:
808-557-6717

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 578784 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".




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