1710152673 NPI number — OASIS TEMPS HEALTH CARE, INC.

Table of content: (NPI 1710152673)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710152673 NPI number — OASIS TEMPS HEALTH CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OASIS TEMPS HEALTH CARE, 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:
1710152673
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4814 26TH STREET WEST
Provider Second Line Business Mailing Address:
UNIT B
Provider Business Mailing Address City Name:
BRADENTON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
941-751-2969
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4814 26TH STREET WEST
Provider Second Line Business Practice Location Address:
UNIT B
Provider Business Practice Location Address City Name:
BRADENTON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
941-751-2969
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/22/2008

Additional Information

Authorized Official

Authorized Official Last Name:
HENRY
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
P
Authorized Official Title or Position:
OWNER/ADMINISTRATOR
Authorized Official Telephone Number:
941-751-2969

Provider Taxonomy Codes

  • Taxonomy code: 251J00000X , with the licence number:  30211114 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 30211114 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 685421400 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 686013398 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 686013396 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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