1891926994 NPI number — HEARING CENTER OF CHESTERTOWN, LLC

Table of content: (NPI 1891926994)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891926994 NPI number — HEARING CENTER OF CHESTERTOWN, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEARING CENTER OF CHESTERTOWN, LLC
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:
1891926994
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/06/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
818 HIGH ST
Provider Second Line Business Mailing Address:
SUITE 3
Provider Business Mailing Address City Name:
CHESTERTOWN
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21620-1152
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-778-5170
Provider Business Mailing Address Fax Number:
410-778-6195

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
818 HIGH ST
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
CHESTERTOWN
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21620-1152
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-778-5170
Provider Business Practice Location Address Fax Number:
410-778-6195
Provider Enumeration Date:
08/06/2009

Additional Information

Authorized Official

Authorized Official Last Name:
MCLENDON
Authorized Official First Name:
BARBARA
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
410-778-5170

Provider Taxonomy Codes

  • Taxonomy code: 237600000X , with the licence number:  00620 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3409241 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1M67BA . This is a "BC/BS OF MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: J395 . This is a "FEDERAL BC/BS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: G2 . This is a "COVENTRY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2130571 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com