1326233453 NPI number — HOME CARE DOCTORS, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326233453 NPI number — HOME CARE DOCTORS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOME CARE DOCTORS, INC
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:
1326233453
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/10/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 ELIZABETH PL
Provider Second Line Business Mailing Address:
STE 280
Provider Business Mailing Address City Name:
DAYTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45417-3445
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-424-5470
Provider Business Mailing Address Fax Number:
937-424-5486

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 ELIZABETH PL
Provider Second Line Business Practice Location Address:
STE 280
Provider Business Practice Location Address City Name:
DAYTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45417-3445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-424-5470
Provider Business Practice Location Address Fax Number:
937-424-5486
Provider Enumeration Date:
09/11/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WU
Authorized Official First Name:
JINYUN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
937-424-5470

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2431827 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".