1962404913 NPI number — ABLE HEALTHCARE SERVICE, INC.

Table of content: (NPI 1962404913)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962404913 NPI number — ABLE HEALTHCARE SERVICE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABLE HEALTHCARE SERVICE, 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:
ABLE HEALTH CARE SERVICE, INC. CONTRACT
Provider Other Organization Name Type Code:
5
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:
1962404913
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/27/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1240 BROADCAST PLZ
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MERRICK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11566-3461
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-546-8000
Provider Business Mailing Address Fax Number:
516-546-2360

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1240 BROADCAST PLZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MERRICK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11566-3461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-546-8000
Provider Business Practice Location Address Fax Number:
516-546-2360
Provider Enumeration Date:
06/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SHAPIRO
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
516-546-8000

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  9315 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00354678 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00853407 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com