1992865661 NPI number — PAR LABORATORY

Table of content: GAIL MIRANDA RICKER APRN (NPI 1245680487)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992865661 NPI number — PAR LABORATORY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PAR LABORATORY
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:
1992865661
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6150 150TH AVE N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEARWATER
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33760-2138
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-538-7227
Provider Business Mailing Address Fax Number:
727-507-6204

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6150 150TH AVE N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEARWATER
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33760-2138
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-538-7227
Provider Business Practice Location Address Fax Number:
727-507-6204
Provider Enumeration Date:
12/11/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HAMILTON
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
727-545-7564

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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