1326128836 NPI number — ELLWOOD CITY HOME HEALTH OPERATIONS, 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 1326128836 NPI number — ELLWOOD CITY HOME HEALTH OPERATIONS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ELLWOOD CITY HOME HEALTH OPERATIONS, 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:
1326128836
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/31/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
724 PERSHING ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELLWOOD CITY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16117-1474
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-752-6748
Provider Business Mailing Address Fax Number:
724-752-0966

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
724 PERSHING ST STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELLWOOD CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16117-1474
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-758-2730
Provider Business Practice Location Address Fax Number:
724-752-0966
Provider Enumeration Date:
10/17/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ANNARUMO
Authorized Official First Name:
BEVERLY
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
724-752-6750

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  724805 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 100771854-0009 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1007718540018 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100771854-0010 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".