1821473638 NPI number — WISIGHT MANAGEMENT SUPPLIES LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821473638 NPI number — WISIGHT MANAGEMENT SUPPLIES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WISIGHT MANAGEMENT SUPPLIES 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:
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:
1821473638
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/22/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
400 E ROYAL LN
Provider Second Line Business Mailing Address:
BUILDING THREE STE. 290
Provider Business Mailing Address City Name:
IRVING
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75039-3540
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-869-7623
Provider Business Mailing Address Fax Number:
888-330-7541

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 E ROYAL LN
Provider Second Line Business Practice Location Address:
BUILDING THREE STE. 290
Provider Business Practice Location Address City Name:
IRVING
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75039-3540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-869-7623
Provider Business Practice Location Address Fax Number:
888-330-7541
Provider Enumeration Date:
07/22/2015

Additional Information

Authorized Official

Authorized Official Last Name:
CHUNN
Authorized Official First Name:
DENISE
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
972-869-7623

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  1001600 , 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)





Copyright © 2007-2025 www.npivalidator.com