1598751489 NPI number — P R HORTON RPH, INC

Table of content: (NPI 1598751489)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598751489 NPI number — P R HORTON RPH, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
P R HORTON RPH, 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:
CONTINUE CARE HOME INFUSION
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:
1598751489
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2609 APACHE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SIOUX CITY
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
51104-1504
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
712-224-2845
Provider Business Mailing Address Fax Number:
712-224-2846

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2609 APACHE CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SIOUX CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
51104-1504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
712-224-2845
Provider Business Practice Location Address Fax Number:
712-224-2846
Provider Enumeration Date:
09/26/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HORTON
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
R
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
712-224-2845

Provider Taxonomy Codes

  • Taxonomy code: 251F00000X , with the licence number:  59 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BP3500X , with the licence number: 59 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X , with the licence number: 59 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 8534140 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0208330 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1620613 . This is a "NCPDP NO." identifier . This identifiers is of the category "OTHER".
  • Identifier: 9167250 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".




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