1679625875 NPI number — DAYONE FAMILY HEALTHCARE PC

Table of content: (NPI 1679625875)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679625875 NPI number — DAYONE FAMILY HEALTHCARE PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAYONE FAMILY HEALTHCARE PC
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:
1679625875
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/20/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
363 FREMONT ST
Provider Second Line Business Mailing Address:
SUITE 203
Provider Business Mailing Address City Name:
BATTLE CREEK
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49017-3389
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
269-969-6123
Provider Business Mailing Address Fax Number:
269-969-6122

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
363 FREMONT ST
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
BATTLE CREEK
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49017-3389
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
269-969-6123
Provider Business Practice Location Address Fax Number:
269-969-6122
Provider Enumeration Date:
01/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GALONSKY
Authorized Official First Name:
BRUCE
Authorized Official Middle Name:
WEBER
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
269-969-6123

Provider Taxonomy Codes

  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 032967 . This is a "BCN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 102589658 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: CA2277 . This is a "MEDICARE RR GROUP" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0801302811 . This is a "BCBS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 080185746 . This is a "MEDICARE RR" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 104403915 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0130281 . This is a "BCN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0801329671 . This is a "BCBS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 080062297 . This is a "MEDICARE RR" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 104654227 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00245326 . This is a "MEDICARE RR" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0130348 . This is a "BCN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 080A310740 . This is a "BCBS GROUP" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0101303482 . This is a "BCBS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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