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General NPI Number Information
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NPI Number | 1326212648
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Entity Type | Organization
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Legal Business Name | FOUR ONES ENTERPRISES, LLC
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Dates
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Enumeration Date | 04/17/2008
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Last Update Date | 04/17/2008
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Provider Practice Location Address
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Address Line | 185 W MONTAUK HWY
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City | HAMPTON BAYS
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State | NY
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Zip | 11946-2305
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Country | US
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Telephone | 631-728-5100
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Fax | 631-723-1709
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Provider Business Mailing Address
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Address Line | 185 W MONTAUK HWY
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City | HAMPTON BAYS
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State | NY
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Zip | 11946-2305
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Country | US
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Telephone | 631-728-5100
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Fax | 631-723-1709
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MS. PAULA G WHEELER
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Credential |
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Telephone | 631-728-5100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number |
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License Number State |
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