1821366923 NPI number — ARRHYTHMIA SPECIALISTS, PC

Table of content: (NPI 1821366923)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821366923 NPI number — ARRHYTHMIA SPECIALISTS, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARRHYTHMIA SPECIALISTS, PC
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:
1821366923
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/08/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1870 AMHERST ST.
Provider Second Line Business Mailing Address:
1-C
Provider Business Mailing Address City Name:
WINCHESTER
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-536-2579
Provider Business Mailing Address Fax Number:
540-536-7235

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1870 AMHERST ST.
Provider Second Line Business Practice Location Address:
1-C
Provider Business Practice Location Address City Name:
WINCHESTER
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-536-2579
Provider Business Practice Location Address Fax Number:
540-536-7235
Provider Enumeration Date:
12/05/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KHAN
Authorized Official First Name:
EJAZ
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
540-536-2579

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1821366923 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: DS3898 . This is a "MEDICARE RR" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 3810022265 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".