1649280165 NPI number — SAAD MEDICAL EQUIPMENT, INC.

Table of content: (NPI 1649280165)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649280165 NPI number — SAAD MEDICAL EQUIPMENT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAAD MEDICAL EQUIPMENT, INC.
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:
SAAD HEALTHCARE
Provider Other Organization Name Type Code:
5
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:
1649280165
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/25/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10598 DIBERVILLE BLVD
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
DIBERVILLE
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39540-2465
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
228-432-5622
Provider Business Mailing Address Fax Number:
228-432-0010

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10598 DIBERVILLE BLVD
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
DIBERVILLE
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39540-2465
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
228-432-5622
Provider Business Practice Location Address Fax Number:
228-432-0010
Provider Enumeration Date:
08/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FULGHAM
Authorized Official First Name:
HENRY
Authorized Official Middle Name:
B.
Authorized Official Title or Position:
VICE PRESIDENT OF OPERATIONS
Authorized Official Telephone Number:
251-343-9600

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  03506/11.1 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000012326 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 00040073 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com