1073873964 NPI number — FLEMING-MCRIMMON PROFESSIONAL CORP

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 1073873964 NPI number — FLEMING-MCRIMMON PROFESSIONAL CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FLEMING-MCRIMMON PROFESSIONAL CORP
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:
PAMELA H. FLEMING, DC
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:
1073873964
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/24/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6859 S EASTERN AVE
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89119-0002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-641-3008
Provider Business Mailing Address Fax Number:
702-471-7580

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6859 S EASTERN AVE
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89119-0002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-641-3008
Provider Business Practice Location Address Fax Number:
702-471-7580
Provider Enumeration Date:
05/24/2012

Additional Information

Authorized Official

Authorized Official Last Name:
FLEMING
Authorized Official First Name:
PAMELA
Authorized Official Middle Name:
HAMBLEN
Authorized Official Title or Position:
CHIROPRACTOR
Authorized Official Telephone Number:
702-641-3008

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  B361 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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