Organization
ECONOMIC STIMULUS ACT STUDENT LOAN REFUND 1200 DOLLARS
Active
Parent organization
EPIC SYSTEMS CORPORATION APPLIED INFORMATICS PHYSICIAN
Other names
ECONOMIC STIMULUS ACT STUDENT LOAN REFUND 1200 DOLLARS, EPIC SYSTEMS CORPORATION APPLIED INFORMATICS PHYSICIAN
Organization subpart
Yes
Provider details
NPI number
Legal business name
EPIC SYSTEMS CORPORATION APPLIED INFORMATICS PHYSICIAN
Authorized official
DR. JACOB CORNELIUS PARKER (SPECIALIST TECHNOLOGIST)
(650) 253-0000
Entity
Organization
Contact information
Practice address
5001 HARDY ST STE 8, HATTIESBURG, MS 39402-1308
(601) 307-5339
Mailing address
3301 N MILWAUKEE ST, DENVER, CO 80205-4322
(650) 253-0000
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QG0250X
Genetics Clinic/Center
—
—
261QS1000X
Student Health Clinic/Center
—
—
293D00000X
Physiological Laboratory
—
—
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
587539997
—
MS
Enumeration date
05/30/2019
Last updated
09/30/2020
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