1750056677 NPI number — POINT SURGICAL ASSISTANTS LLC

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 1750056677 NPI number — POINT SURGICAL ASSISTANTS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
POINT SURGICAL ASSISTANTS LLC
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:
1750056677
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/12/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
228 W LINCOLN HIGHWAY 30 # 127
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCHERERVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46375-1854
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-291-8614
Provider Business Mailing Address Fax Number:
630-216-1105

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7146 183RD ST
Provider Second Line Business Practice Location Address:
NUMBER 111
Provider Business Practice Location Address City Name:
TINLEY PARK
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60477
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-291-8614
Provider Business Practice Location Address Fax Number:
630-216-1105
Provider Enumeration Date:
08/12/2021

Additional Information

Authorized Official

Authorized Official Last Name:
GARZA
Authorized Official First Name:
CYNTHIA
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
CO-OWNER
Authorized Official Telephone Number:
630-750-0792

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1881721488 . This is a "SURGICAL ASSISTING GROUP" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com