Provider Demographics
NPI:1750834016
Name:BLAIR TRANSITIONS MHT LLC
Entity Type:Organization
Organization Name:BLAIR TRANSITIONS MHT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF PAYER RELATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:PINCKNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-307-5822
Mailing Address - Street 1:1575 HERITAGE DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-3288
Mailing Address - Country:US
Mailing Address - Phone:844-633-4663
Mailing Address - Fax:
Practice Address - Street 1:2285 S MICHIGAN RD
Practice Address - Street 2:
Practice Address - City:EATON RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:48827-9206
Practice Address - Country:US
Practice Address - Phone:844-633-4663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty