1891842373 NPI number — ARAS FAMILY CARE, P. C.

Table of content: (NPI 1891842373)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891842373 NPI number — ARAS FAMILY CARE, P. C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARAS FAMILY CARE, P. C.
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:
1891842373
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/04/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2267
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DAVENPORT
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52809-2267
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
563-445-7929
Provider Business Mailing Address Fax Number:
563-445-7961

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3904 LILLIE AVE
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
DAVENPORT
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52806-4422
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
563-445-7929
Provider Business Practice Location Address Fax Number:
563-445-7961
Provider Enumeration Date:
01/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BARNES
Authorized Official First Name:
SARA
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OWNER PHYSICIAN
Authorized Official Telephone Number:
563-445-7929

Provider Taxonomy Codes

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

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

  • Identifier: 0274290 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30660 . This is a "WELLMARK BLUE CROSS" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




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