1730345695 NPI number — US PT MANAGED CARE INC

Table of content: (NPI 1730345695)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730345695 NPI number — US PT MANAGED CARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
US PT MANAGED 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:
6
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:
1730345695
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/31/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3413 COX RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23233-2001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-527-1460
Provider Business Mailing Address Fax Number:
804-527-1463

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
WEINSTEIN CTR
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
UNIVERSITY OF RICHMOND
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23173-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-527-1460
Provider Business Practice Location Address Fax Number:
804-527-1463
Provider Enumeration Date:
07/31/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KING
Authorized Official First Name:
JANNA
Authorized Official Middle Name:
P
Authorized Official Title or Position:
VP, AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
713-297-7000

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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