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VACCINE MACHINE LLC NPI 1013240076


NPI Information

NPI: 1013240076
Provider Name: VACCINE MACHINE LLC

Doing Business As: PASSPORT HEALTH OF AUSTIN

Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

CLIA Number: 45D2204463

Address:
631 W 38TH ST STE 1
AUSTIN, TX
ZIP 78705
Phone: (512) 459-0672
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VACCINE MACHINE LLC is a medical specialty clinic center in Austin, TX. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). VACCINE MACHINE LLC NPI is 1013240076. The provider is registered as an organization entity type.
The provider Is Doing Business As Passport Health Of Austin.

The provider's business location address is:

631 W 38TH ST STE 1
AUSTIN, TX
ZIP 78705-251
Phone: (512) 459-0672
Fax: (512) 420-0974

The provider's authorized official is Sidney T Robin .
The authorized official title is Medical Director and has the following contact phone number (512) 459-0672.

The CLIA number assigned to this NPI record is 45D2204463 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/9/2009 and was last updated on 9/9/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM2500XClinic/CenterMedical SpecialtyE2824TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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