1801991260 NPI number — CASE CHIROPRACTIC INCORPORATED

Table of content: (NPI 1801991260)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801991260 NPI number — CASE CHIROPRACTIC INCORPORATED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CASE CHIROPRACTIC INCORPORATED
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:
1801991260
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
207 W CHATHAM ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
APEX
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27502-1895
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-363-0041
Provider Business Mailing Address Fax Number:
919-363-0574

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
207 W CHATHAM ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
APEX
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27502-1895
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-363-0041
Provider Business Practice Location Address Fax Number:
919-363-0574
Provider Enumeration Date:
09/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CASE
Authorized Official First Name:
CARI
Authorized Official Middle Name:
MAY
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
919-363-0041

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2814 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7240176 . This is a "AETNA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 890845J , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2377667 . This is a "AETNA HMO" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 350054455 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 0845J . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 283534 . This is a "MAMSI" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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