1841284452 NPI number — MR. JOHN J GRIFFIN RPH

Table of content: MR. JOHN J GRIFFIN RPH (NPI 1841284452)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841284452 NPI number — MR. JOHN J GRIFFIN RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRIFFIN
Provider First Name:
JOHN
Provider Middle Name:
J
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
RPH
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:
1841284452
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/28/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
777 LESLIE LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRANKFORT
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60423-1033
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
815-469-2820
Provider Business Mailing Address Fax Number:
219-836-5657

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
777 LESLIE LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKFORT
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60423-1033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
815-469-2820
Provider Business Practice Location Address Fax Number:
219-836-5657
Provider Enumeration Date:
09/09/2005

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: 183500000X , with the licence number:  051029079 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 183500000X , with the licence number: 26015904A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 051028079 . This is a "BOARD OF PHARMACY" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 26015904A . This is a "BOARD OF PHARMACY" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com