1972974376 NPI number — AVRM LLC

Table of content: (NPI 1972974376)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972974376 NPI number — AVRM LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AVRM 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:
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:
1972974376
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/03/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10750 COLUMBIA PIKE
Provider Second Line Business Mailing Address:
SUITE 220
Provider Business Mailing Address City Name:
SILVER SPRING
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20901-4402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-328-7246
Provider Business Mailing Address Fax Number:
240-670-7284

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10750 COLUMBIA PIKE
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
SILVER SPRING
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20901-4402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-328-7246
Provider Business Practice Location Address Fax Number:
240-670-7284
Provider Enumeration Date:
10/12/2015

Additional Information

Authorized Official

Authorized Official Last Name:
AKINYEMI
Authorized Official First Name:
TOLULOPE
Authorized Official Middle Name:
KOFI
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
301-328-7246

Provider Taxonomy Codes

  • Taxonomy code: 261QM2500X , with the licence number:  D0077960 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 055948201 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 069780200 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com