1184625196 NPI number — ODYSSEY HEALTHCARE OPERATING A LP

Table of content: (NPI 1184625196)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184625196 NPI number — ODYSSEY HEALTHCARE OPERATING A LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ODYSSEY HEALTHCARE OPERATING A LP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ODYSSEY HEALTHCARE OF BIG SPRING
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184625196
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/01/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
717 N HARWOOD ST
Provider Second Line Business Mailing Address:
SUITE 1500
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75201-6519
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-922-9711
Provider Business Mailing Address Fax Number:
214-922-9752

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1003 E FM 700
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIG SPRING
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79720-5720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-263-5999
Provider Business Practice Location Address Fax Number:
915-263-9998
Provider Enumeration Date:
08/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ALLISON
Authorized Official First Name:
RODNEY
Authorized Official Middle Name:
DIRK
Authorized Official Title or Position:
SR VP & CFO
Authorized Official Telephone Number:
214-922-9711

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  008116 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1004743 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com