1992131916 NPI number — ATRINEA HEALTH LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992131916 NPI number — ATRINEA HEALTH LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ATRINEA HEALTH 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:
ATRINEA HEALTH
Provider Other Organization Name Type Code:
3
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:
1992131916
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/23/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7601 JEFFERSON ST NE
Provider Second Line Business Mailing Address:
SUITE 340
Provider Business Mailing Address City Name:
ALBUQUERQUE
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87109-4494
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-338-3851
Provider Business Mailing Address Fax Number:
505-338-3859

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 HOSPITAL LOOP NE
Provider Second Line Business Practice Location Address:
SUITE 109
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87109-2129
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-923-4646
Provider Business Practice Location Address Fax Number:
505-435-9255
Provider Enumeration Date:
09/23/2013

Additional Information

Authorized Official

Authorized Official Last Name:
KAPLAN
Authorized Official First Name:
GLENDA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CREDENTIALING SPECIALIST
Authorized Official Telephone Number:
505-944-9414

Provider Taxonomy Codes

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

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





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