1326028218 NPI number — PERSONAL TOUCH HOME CARE OF VA, INC

Table of content: (NPI 1326028218)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326028218 NPI number — PERSONAL TOUCH HOME CARE OF VA, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PERSONAL TOUCH HOME CARE OF VA, 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:
1326028218
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/20/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22215 NORTHERN BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAYSIDE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11361-3603
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-468-4747
Provider Business Mailing Address Fax Number:
718-736-7236

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
733 THIMBLE SHOALS BLVD
Provider Second Line Business Practice Location Address:
#150
Provider Business Practice Location Address City Name:
NEWPORT NEWS
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23606-4260
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-595-8005
Provider Business Practice Location Address Fax Number:
757-595-9131
Provider Enumeration Date:
01/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HOLD-WEISS
Authorized Official First Name:
RACHEL
Authorized Official Middle Name:
Authorized Official Title or Position:
ASSOCIATE GENERAL COUNSEL
Authorized Official Telephone Number:
718-468-4747

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 187025 . This is a "ANTHEM HOME CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8702756 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 004970811 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 337222 . This is a "ANTHEM HOSPICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 008772932 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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