1891994661 NPI number — THE WEAVER GROUP INC

Table of content: (NPI 1891994661)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891994661 NPI number — THE WEAVER GROUP INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE WEAVER GROUP 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:
1891994661
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9648 KINGSTON PIKE
Provider Second Line Business Mailing Address:
SUITE 2
Provider Business Mailing Address City Name:
KNOXVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37922-2397
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
865-357-2650
Provider Business Mailing Address Fax Number:
865-357-2652

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9648 KINGSTON PIKE
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37922-2397
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-357-2650
Provider Business Practice Location Address Fax Number:
865-357-2652
Provider Enumeration Date:
07/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WEAVER
Authorized Official First Name:
GARY
Authorized Official Middle Name:
KENT
Authorized Official Title or Position:
PRESIDENT OWNER
Authorized Official Telephone Number:
865-357-2650

Provider Taxonomy Codes

  • Taxonomy code: 237700000X , with the licence number:  587 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com