1265880165 NPI number — FIRSTLIGHT HOMECARE FRANCHISING LLC

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 1265880165 NPI number — FIRSTLIGHT HOMECARE FRANCHISING LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FIRSTLIGHT HOMECARE FRANCHISING LLC
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:
1265880165
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/11/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7870 E KEMPER RD
Provider Second Line Business Mailing Address:
SUITE 440
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45249-1675
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-766-8402
Provider Business Mailing Address Fax Number:
513-830-5003

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7870 E KEMPER RD
Provider Second Line Business Practice Location Address:
SUITE 440
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45249-1675
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-766-8402
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/01/2016

Additional Information

Authorized Official

Authorized Official Last Name:
HARNED
Authorized Official First Name:
ROGER
Authorized Official Middle Name:
Authorized Official Title or Position:
NATIONAL ALLIANCE COORDINATOR
Authorized Official Telephone Number:
513-766-8402

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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