1841405941 NPI number — LINDER PHYSICAL THERAPY & REHABILITATION, P.C.

Table of content: (NPI 1841405941)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841405941 NPI number — LINDER PHYSICAL THERAPY & REHABILITATION, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LINDER PHYSICAL THERAPY & REHABILITATION, P.C.
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:
1841405941
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/11/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7201 W SAGINAW HWY
Provider Second Line Business Mailing Address:
STE. 205
Provider Business Mailing Address City Name:
LANSING
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48917-1131
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
517-321-7809
Provider Business Mailing Address Fax Number:
517-321-7860

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7201 W SAGINAW HWY
Provider Second Line Business Practice Location Address:
STE. 205
Provider Business Practice Location Address City Name:
LANSING
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48917-1131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-321-7809
Provider Business Practice Location Address Fax Number:
517-321-7860
Provider Enumeration Date:
05/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SAMSON
Authorized Official First Name:
RANJITH
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/ADMINISTRATOR
Authorized Official Telephone Number:
517-321-7809

Provider Taxonomy Codes

  • Taxonomy code: 2251X0800X , 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: 15547 . This is a "MCARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1003673 . This is a "MCLAREN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 30674 . This is a "BLUECROSSBLUESHIELDOFMI" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 200000000526 . This is a "PHYSICIANSHEALTHPLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 40-4769029 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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