1679752620 NPI number — HARRIETT B FOSHEE DR.

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 1679752620 NPI number — HARRIETT B FOSHEE DR.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARRIETT B FOSHEE DR.
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:
1679752620
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
122 W COMMERCE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENVILLE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36037-2216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-382-3691
Provider Business Mailing Address Fax Number:
334-382-0289

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
122 W COMMERCE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENVILLE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36037-2216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-382-3691
Provider Business Practice Location Address Fax Number:
334-382-0289
Provider Enumeration Date:
10/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BOGGAN
Authorized Official First Name:
JONE
Authorized Official Middle Name:
REBECCA
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
334-382-3691

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 51058262 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com