1972522159 NPI number — MURPHY FAMILY HEALTH PA

Table of content: (NPI 1972522159)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972522159 NPI number — MURPHY FAMILY HEALTH PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MURPHY FAMILY HEALTH PA
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:
1972522159
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4188 E US HWY 64
Provider Second Line Business Mailing Address:
STE 12
Provider Business Mailing Address City Name:
MURPHY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28906
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-837-1818
Provider Business Mailing Address Fax Number:
828-837-6630

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4188 E US HWY 64
Provider Second Line Business Practice Location Address:
STE 12
Provider Business Practice Location Address City Name:
MURPHY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-837-1818
Provider Business Practice Location Address Fax Number:
828-837-6630
Provider Enumeration Date:
07/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ZIMMER
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
B
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
828-837-1818

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  9800434 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: DG4466 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 5906854 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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