1073897690 NPI number — ALBERT ROSS THARPE SERVICES, LLC

Table of content: (NPI 1073897690)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073897690 NPI number — ALBERT ROSS THARPE SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALBERT ROSS THARPE SERVICES, 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:
ARTS, LLC
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:
1073897690
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/30/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1017
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PARIS
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38242-1017
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
731-644-3344
Provider Business Mailing Address Fax Number:
731-644-3034

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
105 N FENTRESS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38242-4001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
731-644-3344
Provider Business Practice Location Address Fax Number:
731-644-3034
Provider Enumeration Date:
09/30/2011

Additional Information

Authorized Official

Authorized Official Last Name:
GRAY
Authorized Official First Name:
BARBARA
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
PROPRIETOR/CEO
Authorized Official Telephone Number:
731-644-3344

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , with the licence number:  L000000003965 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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