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1629148929 NPI number — MARTIN LM LLC

NPI Number: 1629148929
Health Care Provider/Practitioner: MARTIN LM LLC

Information about “1629148929” NPI (MARTIN LM LLC) exists in 1629148929 in HTML format HTML  |  1629148929 in plain Text format TXT  |  1629148929 in PDF (Portable Document Format) PDF  |  1629148929 in an XML format XML  formats.

NPI Number : 1629148929 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1629148929",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "MARTIN LM LLC",
    "ParentOrgTIN": null,
    "OrgName": "MARTIN LM LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1401 E 100TH ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BLOOMINGTON",
    "MailingAddressStateName": "MN",
    "MailingAddressPostalCode": "55425",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "952-888-7751",
    "MailingAddressFaxNumber": "952-698-3626",
    "FirstLinePracticeLocationAddress": "1401 E 100TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BLOOMINGTON",
    "PracticeLocationAddressStateName": "MN",
    "PracticeLocationAddressPostalCode": "55425",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "952-888-7751",
    "PracticeLocationAddressFaxNumber": "952-698-3626",
    "EnumerationDate": "11/08/2006",
    "LastUpdateDate": "08/03/2009",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "KAUFMAN",
    "AuthorizedOfficialFirstName": "DENVER",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "612-371-0053",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "314000000X",
        "TaxonomyName": "Skilled Nursing Facility",
        "LicenseNumber": "343053",
        "LicenseNumberStateCode": "MN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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