1942312707 NPI number — BAN-NIX HOME MEDICAL EQUIPMENT, INC.

Table of content: (NPI 1942312707)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942312707 NPI number — BAN-NIX HOME MEDICAL EQUIPMENT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BAN-NIX HOME 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:
Provider Other Organization Name Type Code:
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:
1942312707
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/01/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6330
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KAMUELA
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96743-6330
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-885-1925
Provider Business Mailing Address Fax Number:
808-885-3681

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
64-1032 MAMALAHOA HWY
Provider Second Line Business Practice Location Address:
SUITE #306
Provider Business Practice Location Address City Name:
KAMUELA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96743-8441
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-885-1925
Provider Business Practice Location Address Fax Number:
808-885-3681
Provider Enumeration Date:
08/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NICKEL
Authorized Official First Name:
KARL
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
808-885-1925

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X , with the licence number:  W20520452-01 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 07908901 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 20862-9 . This is a "HMSA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com