1134317985 NPI number — WEST END CHIROPRACTIC CENTER INC.

Table of content: (NPI 1134317985)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134317985 NPI number — WEST END CHIROPRACTIC CENTER INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WEST END CHIROPRACTIC CENTER 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:
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:
1134317985
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/23/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 739
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCIOTA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18354-0739
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-992-4140
Provider Business Mailing Address Fax Number:
570-992-4140

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
STATE ROUTE 209
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCIOTA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18354-0739
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-992-4140
Provider Business Practice Location Address Fax Number:
570-992-4140
Provider Enumeration Date:
10/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KAHN
Authorized Official First Name:
LAWRENCE
Authorized Official Middle Name:
S
Authorized Official Title or Position:
OWNER/DOCTOR
Authorized Official Telephone Number:
570-992-4140

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC-003581-L , 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: 22235 . This is a "PA MASTER CARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 5898181 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P1806758 . This is a "FIRST PRIORITY OXFORD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2518569 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 814852 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0855629000 . This is a "PERSONAL CHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 814489 . This is a "FIRST PRIORITY HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2467749 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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