1881845618 NPI number — A M M S INC

Table of content: (NPI 1881845618)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881845618 NPI number — A M M S INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A M M S 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:
6
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:
1881845618
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2289
Provider Second Line Business Mailing Address:
168 PALOS VERDES
Provider Business Mailing Address City Name:
WHITE SALMON
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98672-2289
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-493-1467
Provider Business Mailing Address Fax Number:
509-493-3765

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2727 E BARNETT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEDFORD
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97504-8331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-858-4000
Provider Business Practice Location Address Fax Number:
541-618-1404
Provider Enumeration Date:
10/10/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MCHALE-SASS
Authorized Official First Name:
ANN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
509-493-1467

Provider Taxonomy Codes

  • Taxonomy code: 367500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 029072 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".




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