NPIMap

Organization Active NPI

S.Crider Construction an Supply Corp.

  • Contractor
  • Quincy, IL
National Provider Identifier
1043844293
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Legal business name
S.CRIDER CONSTRUCTION AN SUPPLY CORP.
Practice address
529 Woodbridge Dr.
Quincy, IL 62301
Phone
(217) 779-3350
NPI assigned
Feb 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Stefan Kane Crider Sr.
Title
Owner
Phone
(217) 779-3350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ContractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171W00000X Primary

Addresses

Primary practice location

529 Woodbridge Dr.
Quincy, IL 62301

Mailing address

529 Woodbridge Dr.
Quincy, IL 62301
Phone (217) 779-3350

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582675200000",
    "number": "1043844293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 WOODBRIDGE DR.",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "62301",
            "telephone_number": "217-779-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 WOODBRIDGE DR.",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "62301",
            "telephone_number": "217-779-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S.CRIDER CONSTRUCTION AN SUPPLY CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-26",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A",
        "authorized_official_last_name": "CRIDER",
        "authorized_official_first_name": "STEFAN",
        "authorized_official_middle_name": "KANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-779-3350",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.