1851335459 NPI number — CROSSWAY, INC.

Table of content: (NPI 1851335459)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851335459 NPI number — CROSSWAY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CROSSWAY, 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:
CROSSWAY PEDIATRIC THERAPY
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:
1851335459
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/05/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9129 MONROE RD
Provider Second Line Business Mailing Address:
SUITE 100-105
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28270-2429
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-847-3911
Provider Business Mailing Address Fax Number:
704-442-8724

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9129 MONROE RD
Provider Second Line Business Practice Location Address:
SUITE 100-015
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28270-2429
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-847-3911
Provider Business Practice Location Address Fax Number:
704-847-2033
Provider Enumeration Date:
06/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DEAN
Authorized Official First Name:
SHELLEY
Authorized Official Middle Name:
ANNE
Authorized Official Title or Position:
OWNER, OCCUPATIONAL THERAPIST
Authorized Official Telephone Number:
704-607-0014

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 183EE . This is a "BCBS INDIVIDUAL NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7211844 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 017H3 . This is a "GROUP NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7301435 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: B0333 . This is a "MEDCOST INDIVIDUAL NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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