1861519399 NPI number — CENTRAL HAND THERAPY PC

Table of content: (NPI 1861519399)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861519399 NPI number — CENTRAL HAND THERAPY PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRAL HAND THERAPY 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:
1861519399
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/27/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 30550
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85751-0550
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-321-1495
Provider Business Mailing Address Fax Number:
520-321-1593

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2810 N ALVERNON WAY
Provider Second Line Business Practice Location Address:
SUITE 600
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85712-1535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-321-1495
Provider Business Practice Location Address Fax Number:
520-321-1593
Provider Enumeration Date:
03/22/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GROVER
Authorized Official First Name:
JULIA
Authorized Official Middle Name:
E
Authorized Official Title or Position:
OWNER PRESIDENT
Authorized Official Telephone Number:
520-321-1495

Provider Taxonomy Codes

  • Taxonomy code: 225XH1200X , with the licence number:  1050 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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