1093044646 NPI number — MOUNT ARARAT BAPTIST CHURCH

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093044646 NPI number — MOUNT ARARAT BAPTIST CHURCH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOUNT ARARAT BAPTIST CHURCH
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:
6
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:
1093044646
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/10/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
271 PAULSON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15206-3270
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-441-1800
Provider Business Mailing Address Fax Number:
412-441-5406

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
271 PAULSON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15206-3270
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-441-1800
Provider Business Practice Location Address Fax Number:
412-441-5406
Provider Enumeration Date:
12/10/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TINSLEY
Authorized Official First Name:
TAUNYA
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
412-441-1800

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  CW006827L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: PC004362 , 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)