1881670313 NPI number — DRS O'GARA, CAPURRO, & ZAMBONI, ET AL RALSTON MEDICAL LTD

Table of content: (NPI 1881670313)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881670313 NPI number — DRS O'GARA, CAPURRO, & ZAMBONI, ET AL RALSTON MEDICAL LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DRS O'GARA, CAPURRO, & ZAMBONI, ET AL RALSTON MEDICAL LTD
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:
RALSTON MEDICAL LTD
Provider Other Organization Name Type Code:
3
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:
1881670313
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/13/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 34120
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RENO
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89533-4120
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
775-747-5050
Provider Business Mailing Address Fax Number:
775-747-5050

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 RALSTON STREET
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
RENO
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89503-4482
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-747-5050
Provider Business Practice Location Address Fax Number:
775-788-8075
Provider Enumeration Date:
12/16/2005

Additional Information

Authorized Official

Authorized Official Last Name:
TORRES
Authorized Official First Name:
VERONICA
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
775-747-5050

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: V33585 . This is a "PTAN MEDICARE" identifier . This identifiers is of the category "OTHER".




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