1467434761 NPI number — MOSES TAYLOR HOME HEALTH SERVICES

Table of content: (NPI 1467434761)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467434761 NPI number — MOSES TAYLOR HOME HEALTH SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOSES TAYLOR HOME HEALTH SERVICES
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:
1467434761
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/06/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
700 QUINCY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCRANTON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18510-1724
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-340-2700
Provider Business Mailing Address Fax Number:
570-340-2799

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 QUINCY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCRANTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18510-1724
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-340-2700
Provider Business Practice Location Address Fax Number:
570-340-2799
Provider Enumeration Date:
11/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ROE
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
VP FINANCE
Authorized Official Telephone Number:
570-340-2991

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  761105 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 20007793 . This is a "AMERIHEALTH MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 397611 . This is a "BLUE CROSS INSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 810114 . This is a "FIRST PRIORITY HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2Y5765 . This is a "HEALTH NET INSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000025175 . This is a "MED PLUS THREE RIVERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 75877800 . This is a "FEDERAL BLACK LUNG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007771410018 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2329840 . This is a "AETNA INSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 43016 . This is a "GEISINGER HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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