Provider Demographics
NPI:1053058057
Name:987ONLINECENTRAL LLC
Entity type:Organization
Organization Name:987ONLINECENTRAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELVIS
Authorized Official - Middle Name:JONATHAN
Authorized Official - Last Name:OGUTU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-540-3318
Mailing Address - Street 1:6203 LOVE DR APT 3131
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-4008
Mailing Address - Country:US
Mailing Address - Phone:469-540-3318
Mailing Address - Fax:
Practice Address - Street 1:400 E ROYAL LN STE 290
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-3602
Practice Address - Country:US
Practice Address - Phone:469-540-3318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246YC3301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Hospital BasedGroup - Single Specialty