1639313018 NPI number — CENTER HOME HEALTH CARE INC

Table of content: (NPI 1639313018)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639313018 NPI number — CENTER HOME HEALTH CARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTER HOME HEALTH CARE 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:
CENTER DRUGS
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:
1639313018
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/29/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 528
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHANCELLOR
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36316-0528
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
607A BOLL WEEVIL CIR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ENTERPRISE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36330-2733
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-347-4242
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/29/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SHIVER
Authorized Official First Name:
GEORGE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/OWNER/PHARMACIST
Authorized Official Telephone Number:
334-347-4242

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 113256 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0004X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336S0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 0135916 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".