1922342732 NPI number — ST. MARK'S PHYSICIAN BILLING, LLC

Table of content: (NPI 1922342732)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922342732 NPI number — ST. MARK'S PHYSICIAN BILLING, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ST. MARK'S PHYSICIAN BILLING, LLC
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:
1922342732
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/29/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2000 HEALTH PARK DR STE G200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027-4525
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-373-7406
Provider Business Mailing Address Fax Number:
866-346-1426

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1160 E 3900 S
Provider Second Line Business Practice Location Address:
STE G200
Provider Business Practice Location Address City Name:
SALT LAKE CITY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84124-1202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-268-7766
Provider Business Practice Location Address Fax Number:
801-270-3395
Provider Enumeration Date:
11/16/2012

Additional Information

Authorized Official

Authorized Official Last Name:
JOSEPH
Authorized Official First Name:
LOUIS
Authorized Official Middle Name:
Authorized Official Title or Position:
VP
Authorized Official Telephone Number:
615-373-7630

Provider Taxonomy Codes

  • Taxonomy code: 261QG0250X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP3300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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