1598719379 NPI number — ALBERT GALLATIN HOME CARE AND HOSPICE SERVICES, LLC

Table of content: (NPI 1598719379)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598719379 NPI number — ALBERT GALLATIN HOME CARE AND HOSPICE SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALBERT GALLATIN HOME CARE AND HOSPICE SERVICES, 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:
AMEDISYS HOME HEALTH OF PA
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:
1598719379
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/14/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3854 AMERICAN WAY
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
BATON ROUGE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70816-4013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-292-2031
Provider Business Mailing Address Fax Number:
225-295-9678

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1368 MALL RUN RD
Provider Second Line Business Practice Location Address:
SUITE 628
Provider Business Practice Location Address City Name:
UNIONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15401-2696
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-438-6660
Provider Business Practice Location Address Fax Number:
724-438-3868
Provider Enumeration Date:
05/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GOFF
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
U
Authorized Official Title or Position:
DELEGATED OFFICIAL
Authorized Official Telephone Number:
225-299-3701

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  713905 , 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: 254340 . This is a "HEALTH AMERICA PA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 212057 . This is a "UPMC HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1014856420014 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 162461 . This is a "THREE RIVERS HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 201031840034 . This is a "TRICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0757 . This is a "BCBS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1014856420005 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 60634820 . This is a "FEDERAL BLACK LUNG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1014856420001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1014856420002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1014856420004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1069189 . This is a "WORKERS' COMP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1014856420012 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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