1881747590 NPI number — UNITED PATHOLOGY INC.

Table of content: (NPI 1881747590)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881747590 NPI number — UNITED PATHOLOGY INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITED PATHOLOGY 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:
1881747590
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
75 COLONIA DE SALUD
Provider Second Line Business Mailing Address:
SUITE 200D
Provider Business Mailing Address City Name:
SIERRA VISTA
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85635-2487
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-459-1984
Provider Business Mailing Address Fax Number:
520-452-1011

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
75 COLONIA DE SALUD
Provider Second Line Business Practice Location Address:
SUITE 200D
Provider Business Practice Location Address City Name:
SIERRA VISTA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85635-2487
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-459-1984
Provider Business Practice Location Address Fax Number:
520-452-1011
Provider Enumeration Date:
01/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FIELDS
Authorized Official First Name:
JANICE
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
BUSINESS MANAGER
Authorized Official Telephone Number:
520-459-1984

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 220004044 . This is a "RAILROAD MEDICARE PIN" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com