1285735563 NPI number — AARONS HOME HEALTH CARE, LLC

Table of content: (NPI 1285735563)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285735563 NPI number — AARONS HOME HEALTH CARE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AARONS HOME HEALTH CARE, LLC
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:
Provider Other Organization Name Type Code:
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:
1285735563
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
328 BARTLES RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DEWEY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74029-2710
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-534-0100
Provider Business Mailing Address Fax Number:
918-534-0102

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
328 BARTLES RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DEWEY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74029-2710
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-534-0100
Provider Business Practice Location Address Fax Number:
918-534-0102
Provider Enumeration Date:
09/26/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WHITE
Authorized Official First Name:
AARON
Authorized Official Middle Name:
JASON
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
918-534-0100

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 200088510 A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200400680 A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".