1891827408 NPI number — HS1 MEDICAL MANAGEMENT INC

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 1891827408 NPI number — HS1 MEDICAL MANAGEMENT INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HS1 MEDICAL MANAGEMENT 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:
1891827408
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2001 S ANDREWS AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT LAUDERDALE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33316-3429
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-422-3672
Provider Business Mailing Address Fax Number:
305-620-5876

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2001 S ANDREWS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT LAUDERDALE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33316-3429
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-422-3672
Provider Business Practice Location Address Fax Number:
305-620-5876
Provider Enumeration Date:
03/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LEAHY
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
800-422-3672

Provider Taxonomy Codes

  • Taxonomy code: 302R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: COMPANY CODE 168041 . This is a "PRIVATE REVIEW AGENT" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: TPA 44185 . This is a "TPA LICENSE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: TPA20070107 . This is a "TPA" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 992366700 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: CERT # 1702,REG #806 . This is a "PRIVATE REVIEW AGENT" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: CERT 5358 . This is a "PRIVATE REVIEW AGENT" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com