1871811976 NPI number — MONITORING MANAGEMENT PARTNERS MMP PLLC

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 1871811976 NPI number — MONITORING MANAGEMENT PARTNERS MMP PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MONITORING MANAGEMENT PARTNERS MMP PLLC
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:
1871811976
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/08/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1256 HIGH CREST CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRUIT HEIGHTS
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84037-4406
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
855-864-4322
Provider Business Mailing Address Fax Number:
866-540-2867

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9811 W CHARLESTON BLVD
Provider Second Line Business Practice Location Address:
STE. 2-641
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89117-7528
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
855-864-4322
Provider Business Practice Location Address Fax Number:
866-540-2867
Provider Enumeration Date:
05/13/2010

Additional Information

Authorized Official

Authorized Official Last Name:
LUEKENGA
Authorized Official First Name:
NICK
Authorized Official Middle Name:
C
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
855-864-4322

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 293D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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