1942352299 NPI number — CITY OF NEWPORT OFFICE OF CITY CLERK

Table of content: (NPI 1942352299)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942352299 NPI number — CITY OF NEWPORT OFFICE OF CITY CLERK

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF NEWPORT OFFICE OF CITY CLERK
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:
1942352299
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/07/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
615 THIRD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWPORT
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72112-3217
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
870-523-3331
Provider Business Mailing Address Fax Number:
870-512-2101

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1206 HIGHWAY 367 N
Provider Second Line Business Practice Location Address:
615 3RD STREET
Provider Business Practice Location Address City Name:
NEWPORT
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72112-2565
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-523-3331
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GANSZ
Authorized Official First Name:
ALAN
Authorized Official Middle Name:
Authorized Official Title or Position:
ASST. CHIEF
Authorized Official Telephone Number:
870-523-3331

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  288 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 288 . This is a "STATE LICENSE NUMBER" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 102823715 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".




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