1154447720 NPI number — HOME PRODUCTS FOR SENIORS, INC.

Table of content: (NPI 1154447720)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154447720 NPI number — HOME PRODUCTS FOR SENIORS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOME PRODUCTS FOR SENIORS, 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:
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:
1154447720
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/13/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1250 WEST DOROTHY LANE
Provider Second Line Business Mailing Address:
SUITE 303
Provider Business Mailing Address City Name:
DAYTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45409-1317
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-847-1700
Provider Business Mailing Address Fax Number:
937-847-1866

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1250 WEST DOROTHY LANE
Provider Second Line Business Practice Location Address:
SUITE 303
Provider Business Practice Location Address City Name:
DAYTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45409-1317
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-847-1700
Provider Business Practice Location Address Fax Number:
937-847-1866
Provider Enumeration Date:
03/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DONAHUE
Authorized Official First Name:
LESLIE
Authorized Official Middle Name:
D.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
937-847-1700

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , 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: 418110700 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200872920A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2642000 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 66454816 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9058264 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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