1922387448 NPI number — ROYAL VICTORIA HOSPITAL

Table of content: (NPI 1922387448)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922387448 NPI number — ROYAL VICTORIA HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROYAL VICTORIA HOSPITAL
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:
1922387448
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/15/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
687 PINE AVE
Provider Second Line Business Mailing Address:
S10.26
Provider Business Mailing Address City Name:
MONTREAL
Provider Business Mailing Address State Name:
QC
Provider Business Mailing Address Postal Code:
H3A1A1
Provider Business Mailing Address Country Code:
CA
Provider Business Mailing Address Telephone Number:
514-834-1934
Provider Business Mailing Address Fax Number:
514-843-1503

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
687 PINE AVE
Provider Second Line Business Practice Location Address:
S10.26
Provider Business Practice Location Address City Name:
MONTREAL
Provider Business Practice Location Address State Name:
QC
Provider Business Practice Location Address Postal Code:
H3A1A1
Provider Business Practice Location Address Country Code:
CA
Provider Business Practice Location Address Telephone Number:
514-834-1934
Provider Business Practice Location Address Fax Number:
514-843-1503
Provider Enumeration Date:
08/15/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
METRAKOS
Authorized Official First Name:
PETER
Authorized Official Middle Name:
Authorized Official Title or Position:
PROGRAM DIRECTOR HEPATOBILIARY
Authorized Official Telephone Number:
514-843-1600

Provider Taxonomy Codes

  • Taxonomy code: 284300000X , with the licence number:  11RM0003174 , registered in the state of ZZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X , with the licence number: 09449 , registered in the state of ZZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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