1649385865 NPI number — CRAWFORD COUNTY SHARED HEALTH SERVICES

Table of content: (NPI 1649385865)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649385865 NPI number — CRAWFORD COUNTY SHARED HEALTH SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CRAWFORD COUNTY SHARED HEALTH SERVICES
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:
HOMECARE MATTERS HOME HEALTH & HOSPICE
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:
1649385865
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1220 N MARKET ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GALION
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44833-1443
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-468-7985
Provider Business Mailing Address Fax Number:
419-468-9211

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1220 N MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GALION
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44833-1443
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-468-7985
Provider Business Practice Location Address Fax Number:
419-468-9211
Provider Enumeration Date:
08/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
EARL
Authorized Official First Name:
NATALIE
Authorized Official Middle Name:
Authorized Official Title or Position:
FINANCE DIRECTOR
Authorized Official Telephone Number:
419-462-8002

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251G00000X , with the licence number: 0042HSP , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 600006 . This is a "UNITED HEALTH CARE OHIO" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 5839305 . This is a "PASSPORT" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: Y29 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 03503 . This is a "PARAMOUNT ELITE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0606900 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2007483 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 708465 . This is a "BLACK LUNG" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2007429 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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