Provider Demographics
NPI: | 1821403304 |
---|---|
Name: | ON-LINE TRAINING CENTER,INC. |
Entity type: | Organization |
Organization Name: | ON-LINE TRAINING CENTER,INC. |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | DELORES |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | GREGORY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 314-522-3077 |
Mailing Address - Street 1: | 1552 KNOLLWAY DR |
Mailing Address - Street 2: | |
Mailing Address - City: | FERGUSON |
Mailing Address - State: | MO |
Mailing Address - Zip Code: | 63135-1406 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 314-522-3077 |
Mailing Address - Fax: | 314-381-3311 |
Practice Address - Street 1: | 1552 KNOLLWAY DR |
Practice Address - Street 2: | |
Practice Address - City: | FERGUSON |
Practice Address - State: | MO |
Practice Address - Zip Code: | 63135-1406 |
Practice Address - Country: | US |
Practice Address - Phone: | 314-522-3077 |
Practice Address - Fax: | 314-381-3311 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-06-24 |
Last Update Date: | 2014-06-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MO | 163W00000X, 163WA0400X, 163WC1600X, 163WC2100X, 163WD0400X, 163WH0200X, 163WS0200X, 163WW0000X, 164W00000X, 164X00000X, 246YC3301X, 246YC3302X, 2471R0002X, 390200000X, 163WD1100X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 163WD1100X | Nursing Service Providers | Registered Nurse | Dialysis, Peritoneal | Group - Single Specialty |
No | 163W00000X | Nursing Service Providers | Registered Nurse | Group - Single Specialty | |
No | 163WA0400X | Nursing Service Providers | Registered Nurse | Addiction (Substance Use Disorder) | Group - Single Specialty |
No | 163WC1600X | Nursing Service Providers | Registered Nurse | Continuing Education/Staff Development | Group - Single Specialty |
No | 163WC2100X | Nursing Service Providers | Registered Nurse | Continence Care | Group - Single Specialty |
No | 163WD0400X | Nursing Service Providers | Registered Nurse | Diabetes Educator | Group - Single Specialty |
No | 163WH0200X | Nursing Service Providers | Registered Nurse | Home Health | Group - Single Specialty |
No | 163WS0200X | Nursing Service Providers | Registered Nurse | School | Group - Single Specialty |
No | 163WW0000X | Nursing Service Providers | Registered Nurse | Wound Care | Group - Single Specialty |
No | 164W00000X | Nursing Service Providers | Licensed Practical Nurse | Group - Single Specialty | |
No | 164X00000X | Nursing Service Providers | Licensed Vocational Nurse | Group - Single Specialty | |
No | 246YC3301X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Health Information | Coding Specialist, Hospital Based | Group - Single Specialty |
No | 246YC3302X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Health Information | Coding Specialist, Physician Office Based | Group - Single Specialty |
No | 2471R0002X | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Radiation Therapy | Group - Single Specialty |
No | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program | Group - Single Specialty |