1144225434 NPI number — CAROL J SCHUMACHER CNP

Table of content: CAROL J SCHUMACHER CNP (NPI 1144225434)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144225434 NPI number — CAROL J SCHUMACHER CNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHUMACHER
Provider First Name:
CAROL
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CNP
Provider Gender Code:
F

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:
1144225434
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/03/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 MATTHEW ST
Provider Second Line Business Mailing Address:
ATTN: CASHIERS
Provider Business Mailing Address City Name:
MARIETTA
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45750-1635
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-374-1413
Provider Business Mailing Address Fax Number:
740-376-5078

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
108 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WOODSFIELD
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43793-1023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-472-1330
Provider Business Practice Location Address Fax Number:
740-472-1336
Provider Enumeration Date:
06/15/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  COA.05662.NP , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2252977 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: P01514295 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 7102161000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000652916 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".