1821034638 NPI number — HUGH URBAN ARMBRUSTER

Table of content: HUGH URBAN ARMBRUSTER (NPI 1821034638)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821034638 NPI number — HUGH URBAN ARMBRUSTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARMBRUSTER
Provider First Name:
HUGH
Provider Middle Name:
URBAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

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:
1821034638
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/28/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
127 N RIVER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FENTON
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48430-3800
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-750-0320
Provider Business Mailing Address Fax Number:
810-767-4060

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
127 N RIVER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FENTON
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48430-3800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-750-0320
Provider Business Practice Location Address Fax Number:
810-767-4060
Provider Enumeration Date:
06/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  6301002268 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 6801019131 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 028363 . This is a "VALUE OPTIONS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 258694 . This is a "MHN PIN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 5266701 . This is a "AETNA BEHAVIORAL HEALTH" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0911419 . This is a "BCBSM MESSA/MEGELLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1063603106 . This is a "HEALTH PLUS PIN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 7509104190 . This is a "BCBSM MENTAL HEALTH PIN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 130958 . This is a "CARE CHOICES & PREFERRED" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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