1346282845 NPI number — AMERICARE HEALTH SERVICES CORPORATION

Table of content: (NPI 1346282845)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346282845 NPI number — AMERICARE HEALTH SERVICES CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICARE HEALTH SERVICES 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:
AMERICARE
Provider Other Organization Name Type Code:
3
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:
1346282845
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/08/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 SUN AVE NE
Provider Second Line Business Mailing Address:
COMPLIANCE DEPARTMENT
Provider Business Mailing Address City Name:
ALBUQUERQUE
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87109-4373
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-468-5604
Provider Business Mailing Address Fax Number:
505-468-4681

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 SUN AVE NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87109-4373
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-468-4678
Provider Business Practice Location Address Fax Number:
505-468-8013
Provider Enumeration Date:
06/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NYLAND
Authorized Official First Name:
PETER
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT-DIRECTOR
Authorized Official Telephone Number:
505-821-3355

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  1477 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BN1400X , with the licence number: 1477 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BP3500X , with the licence number: 1477 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 4581494 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 804002800 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 806032400 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: G4622 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9107282 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 011269001 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 625357009 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000515699A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 561101 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 48755508 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 90003112 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 009105980 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1188573 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200251170A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30761325 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2229565 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7702040 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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