1932264058 NPI number — ALOTAD, INC.

Table of content: (NPI 1932264058)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932264058 NPI number — ALOTAD, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALOTAD, 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:
DBA THE HOMETOWN PHARMACY
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:
1932264058
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/21/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8571 FOXWOOD CT.
Provider Second Line Business Mailing Address:
STE. A
Provider Business Mailing Address City Name:
POLAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44514
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-318-3926
Provider Business Mailing Address Fax Number:
330-318-3927

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
49 PINE GROVE PL.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GROVE CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-458-1900
Provider Business Practice Location Address Fax Number:
724-458-6500
Provider Enumeration Date:
12/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCDERMOTT
Authorized Official First Name:
RONALD
Authorized Official Middle Name:
Authorized Official Title or Position:
VP OPERATIONS
Authorized Official Telephone Number:
330-318-3926

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  PP481668 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PP481668 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 102680561-0001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 536250 . This is a "FLU PTAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com