1013346634 NPI number — MR. ALEC HIGGINS RIMMASCH JR. NP-C

Table of content: MR. ALEC HIGGINS RIMMASCH JR. NP-C (NPI 1013346634)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013346634 NPI number — MR. ALEC HIGGINS RIMMASCH JR. NP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIMMASCH
Provider First Name:
ALEC
Provider Middle Name:
HIGGINS
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
NP-C
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RIMMASCH
Provider Other First Name:
AJ
Provider Other Middle Name:
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
NP-C
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1013346634
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/04/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
175 N 100 W STE 104
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VERNAL
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84078-2054
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
435-781-3053
Provider Business Mailing Address Fax Number:
435-781-3055

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
175 N 100 W STE 104
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VERNAL
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84078-2054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-781-3053
Provider Business Practice Location Address Fax Number:
435-781-3055
Provider Enumeration Date:
11/04/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  6590438-4405 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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