1720287329 NPI number — RICHARD N. LANGDON D.C.P.C.

Table of content: (NPI 1720287329)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720287329 NPI number — RICHARD N. LANGDON D.C.P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RICHARD N. LANGDON D.C.P.C.
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:
CROSS VALLEY CHIROPRACTIC CENTER
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:
1720287329
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/19/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
250 S RIVER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLAINS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18705-1143
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-822-4848
Provider Business Mailing Address Fax Number:
570-822-4879

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
250 S RIVER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLAINS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18705-1143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-822-4848
Provider Business Practice Location Address Fax Number:
570-822-4879
Provider Enumeration Date:
07/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LANGDON
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
NEAL
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
570-822-4848

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0006453910001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 077910 . This is a "FIRST PRIORITY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 4408741 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 567086 . This is a "BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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