1972071884 NPI number — OUR HEALTH LAB INC

Table of content: (NPI 1972071884)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972071884 NPI number — OUR HEALTH LAB INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OUR HEALTH LAB 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:
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:
1972071884
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3 SPRING PARK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28805-1801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-608-0600
Provider Business Mailing Address Fax Number:
828-633-5390

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1411 ASHEVILLE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HENDERSONVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28791-2301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-608-0600
Provider Business Practice Location Address Fax Number:
828-633-5390
Provider Enumeration Date:
11/08/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SAVAGE
Authorized Official First Name:
CATRIONA
Authorized Official Middle Name:
SARAH
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
828-608-0600

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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