1790794071 NPI number — FLANEL HEALTHCARE SERVICES LLC

Table of content: (NPI 1790794071)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790794071 NPI number — FLANEL HEALTHCARE SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FLANEL HEALTHCARE SERVICES 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:
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:
1790794071
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/15/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 SOUTH 9TH STREET
Provider Second Line Business Mailing Address:
SUITE #204
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77469
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-633-2800
Provider Business Mailing Address Fax Number:
281-633-2601

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 SOUTH 9TH STREET
Provider Second Line Business Practice Location Address:
SUITE #204
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77469
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-633-2800
Provider Business Practice Location Address Fax Number:
281-633-2601
Provider Enumeration Date:
08/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BABALOLA
Authorized Official First Name:
ELIZABETH
Authorized Official Middle Name:
A
Authorized Official Title or Position:
ADMINSTRATOR DON DIRECTOR OF NURSIN
Authorized Official Telephone Number:
281-633-2800

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  010565 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 010565 . This is a "STATE LICENSE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com