1104879634 NPI number — HUB CITY HOME HEALTH INC

Table of content: (NPI 1104879634)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104879634 NPI number — HUB CITY HOME HEALTH INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HUB CITY HOME HEALTH 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:
AMERICAN MEDICAL HOME HEALTH SERVICES
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:
1104879634
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/01/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
506 VALLEY BROOK RD STE 201
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCMURRAY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15317-9610
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-684-4550
Provider Business Mailing Address Fax Number:
724-684-5944

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5151 FLYNN PKWY STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORPUS CHRISTI
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78411-4318
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-887-9760
Provider Business Practice Location Address Fax Number:
361-887-9767
Provider Enumeration Date:
05/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DOJONOVIC
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT CEO
Authorized Official Telephone Number:
724-684-4550

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  003177 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 001003629 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 024681101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001013837 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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