1639301344 NPI number — NATIONAL HOME MODIFICATION 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 1639301344 NPI number — NATIONAL HOME MODIFICATION INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONAL HOME MODIFICATION 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:
1639301344
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/22/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9155 MARSHALL RD
Provider Second Line Business Mailing Address:
LOWER LEVEL SUITE 102B
Provider Business Mailing Address City Name:
CRANBERRY TWP
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16066-2917
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-452-7475
Provider Business Mailing Address Fax Number:
724-452-5381

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9155 MARSHALL RD
Provider Second Line Business Practice Location Address:
LOWER LEVEL SUITE 102B
Provider Business Practice Location Address City Name:
CRANBERRY TWP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16066
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-452-7475
Provider Business Practice Location Address Fax Number:
724-452-5381
Provider Enumeration Date:
08/13/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MAROWITZ
Authorized Official First Name:
RANDY
Authorized Official Middle Name:
RANDY
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
724-452-7475

Provider Taxonomy Codes

  • Taxonomy code: 171WH0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1023756720003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".