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1740442581 NPI number — CRYSTAL NEW HOPE MEDICAL CLINIC

NPI Number: 1740442581
Health Care Provider/Practitioner: CRYSTAL NEW HOPE MEDICAL CLINIC

Information about “1740442581” NPI (CRYSTAL NEW HOPE MEDICAL CLINIC) exists in 1740442581 in HTML format HTML  |  1740442581 in plain Text format TXT  |  1740442581 in PDF (Portable Document Format) PDF  |  1740442581 in an XML format XML  formats.

NPI Number : 1740442581 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1740442581",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "CRYSTAL NEW HOPE MEDICAL CLINIC",
    "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": "3501 N DOUGLAS DRIVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CRYSTAL",
    "MailingAddressStateName": "MN",
    "MailingAddressPostalCode": "55422",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "763-535-9601",
    "MailingAddressFaxNumber": "763-535-5601",
    "FirstLinePracticeLocationAddress": "3501 DOUGLAS DR N",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CRYSTAL",
    "PracticeLocationAddressStateName": "MN",
    "PracticeLocationAddressPostalCode": "55422-2415",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "763-535-9601",
    "PracticeLocationAddressFaxNumber": "763-535-5601",
    "EnumerationDate": "07/01/2008",
    "LastUpdateDate": "07/01/2008",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "EVENS",
    "AuthorizedOfficialFirstName": "MARGARET",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OFFICE MANAGER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "763-535-9601",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "332B00000X",
        "TaxonomyName": "Durable Medical Equipment & Medical Supplies",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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