1639212103 NPI number — PAHWAYS OF DELAWARE

Table of content: (NPI 1639212103)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639212103 NPI number — PAHWAYS OF DELAWARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PAHWAYS OF DELAWARE
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:
PATHWAYS OF DELAWARE
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:
1639212103
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/21/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 ROGERS RD.
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
WILMINGTON
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-573-5073
Provider Business Mailing Address Fax Number:
302-573-5072

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 ROGERS RD.
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-573-5073
Provider Business Practice Location Address Fax Number:
302-573-5072
Provider Enumeration Date:
02/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RICHEY
Authorized Official First Name:
SHARON
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMIN. ASST./BILLER
Authorized Official Telephone Number:
302-573-5073

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  PC-0000785 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103K00000X , with the licence number: PC-103K00000X , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103K00000X , with the licence number: PC-0000803 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TR0400X , with the licence number: PC-0000803 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: Q1-0001173 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: Q1-0001015 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: Q1-0001507 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 132643815 . This is a "SOCIAL WORKER" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 1932422391 . This is a "SOCIAL WORKER" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 1699110015 . This is a "SOCIAL WORKER" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 1760712202 . This is a "SOCIAL WORKER" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 1346789369 . This is a "SOCIAL WORKER" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".




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