1336664960 NPI number — ALBERT GALLATIN HUMAN SERVICES

Table of content: (NPI 1336664960)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336664960 NPI number — ALBERT GALLATIN HUMAN SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALBERT GALLATIN HUMAN SERVICES
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:
1336664960
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22 S MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MASONTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15461-2040
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-583-7822
Provider Business Mailing Address Fax Number:
724-583-8357

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22 SOUTH MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MASONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-583-7822
Provider Business Practice Location Address Fax Number:
724-583-8357
Provider Enumeration Date:
08/04/2017

Additional Information

Authorized Official

Authorized Official Last Name:
DUNHAM
Authorized Official First Name:
KRISTIN
Authorized Official Middle Name:
S.
Authorized Official Title or Position:
CEO/DIRECTOR
Authorized Official Telephone Number:
724-583-7822

Provider Taxonomy Codes

  • Taxonomy code: 174200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com