1801260906 NPI number — WALTER/MCCANN, INC.

Table of content: (NPI 1801260906)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801260906 NPI number — WALTER/MCCANN, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WALTER/MCCANN, 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:
1801260906
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/30/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2850 MCCLELLAND DR STE 1900
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT COLLINS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80525-2576
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-494-1111
Provider Business Mailing Address Fax Number:
970-226-4790

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2850 MCCLELLAND DR STE 1900
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT COLLINS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80525-2576
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-494-1111
Provider Business Practice Location Address Fax Number:
970-226-4790
Provider Enumeration Date:
11/30/2015

Additional Information

Authorized Official

Authorized Official Last Name:
WALTER
Authorized Official First Name:
PATTI
Authorized Official Middle Name:
J
Authorized Official Title or Position:
AGENCY MANAGER/OWNER
Authorized Official Telephone Number:
970-494-1111

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , with the licence number:  04O530 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 04O530 . This is a "STATE LICENSE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com