1851631147 NPI number — THERAPY SUPPORT INC

Table of content: (NPI 1851631147)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851631147 NPI number — THERAPY SUPPORT INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THERAPY SUPPORT INC
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:
1851631147
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/22/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2803 N OAK GROVE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65803-4976
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
417-380-5105
Provider Business Mailing Address Fax Number:
417-447-0987

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 VILLANI DR
Provider Second Line Business Practice Location Address:
SUITE 3005
Provider Business Practice Location Address City Name:
BRIDGEVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15017-3483
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-221-3500
Provider Business Practice Location Address Fax Number:
412-221-3555
Provider Enumeration Date:
02/22/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PAVLIN
Authorized Official First Name:
RUSCELL
Authorized Official Middle Name:
D
Authorized Official Title or Position:
3M DIRECTOR
Authorized Official Telephone Number:
417-380-5105

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X , with the licence number:  8000002457 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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