1285720482 NPI number — COMMUNITY CAREPARTNERS, INC

Table of content: (NPI 1285720482)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285720482 NPI number — COMMUNITY CAREPARTNERS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY CAREPARTNERS, 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:
1285720482
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/26/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
68 SWEETEN CREEK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28803-2318
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-274-2400
Provider Business Mailing Address Fax Number:
828-279-4808

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 DOCTORS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28801-4608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-254-3392
Provider Business Practice Location Address Fax Number:
828-254-4380
Provider Enumeration Date:
10/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GILLESPIE
Authorized Official First Name:
SHELLEY
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING SPECIALIST
Authorized Official Telephone Number:
828-277-4800

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X , with the licence number: H0081 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 046FX . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 2444136 . This is a "UNITED HEALTH CARE PROV #" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7703519 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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