1326575044 NPI number — MAXMATH TUTORING ONLINE INC, PENNSYLVANIA BRANCH CORPORATION

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 1326575044 NPI number — MAXMATH TUTORING ONLINE INC, PENNSYLVANIA BRANCH CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MAXMATH TUTORING ONLINE INC, PENNSYLVANIA BRANCH CORPORATION
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:
1326575044
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/12/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
217 CAMERON DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOBYHANNA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18466-8195
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-959-4159
Provider Business Mailing Address Fax Number:
888-959-4173

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
217 CAMERON DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOBYHANNA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18466-8195
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-959-4159
Provider Business Practice Location Address Fax Number:
888-959-4173
Provider Enumeration Date:
05/12/2017

Additional Information

Authorized Official

Authorized Official Last Name:
DECARDE
Authorized Official First Name:
JEAN
Authorized Official Middle Name:
MAXCENE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
570-580-4114

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  6551837 , 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)





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