1689719403 NPI number — BLUEFIELD PULMONARY CONSULTANTS, INC.

Table of content: (NPI 1689719403)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689719403 NPI number — BLUEFIELD PULMONARY CONSULTANTS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BLUEFIELD PULMONARY CONSULTANTS, 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:
1689719403
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 90
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLUEFIELD
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
24701-0090
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
276-322-3947
Provider Business Mailing Address Fax Number:
276-322-2344

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
103 WESTWOOD CMN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLUEFIELD
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24605-2031
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
276-322-3947
Provider Business Practice Location Address Fax Number:
276-322-2344
Provider Enumeration Date:
02/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FIGUEROA
Authorized Official First Name:
OSCAR
Authorized Official Middle Name:
FERNANDO
Authorized Official Title or Position:
C.E.O.
Authorized Official Telephone Number:
276-322-3947

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QS1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1061838 . This is a "STATE WORKERS' COMPENSATI" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 010151100 . This is a "FEDERAL BLACK LUNG" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4461750 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3810007341 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010000238 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 180913 . This is a "ANTHEM BLUE CROSS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 001712425 . This is a "MOUNTAIN STATE BLUE CROSS" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".




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