1639357635 NPI number — KROL CHIROPRACTIC CENTER PA

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 1639357635 NPI number — KROL CHIROPRACTIC CENTER PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KROL CHIROPRACTIC CENTER PA
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:
CARROLL CHIROPRACTIC CENTER
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:
1639357635
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8439
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DELRAY BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33482-8439
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-498-8005
Provider Business Mailing Address Fax Number:
561-498-2222

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5180 W ATLANTIC AVE
Provider Second Line Business Practice Location Address:
SUITE 123
Provider Business Practice Location Address City Name:
DELRAY BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33484-8103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-498-8005
Provider Business Practice Location Address Fax Number:
561-498-2222
Provider Enumeration Date:
02/01/2008

Additional Information

Authorized Official

Authorized Official Last Name:
KROL
Authorized Official First Name:
CAROL
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
CHIROPRACTIC PHYSICIAN
Authorized Official Telephone Number:
561-498-8005

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  CH3887 , 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)

  • Identifier: 380231100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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