1356366231 NPI number — AT HOME SOLUTIONS, INC.

Table of content: (NPI 1356366231)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356366231 NPI number — AT HOME SOLUTIONS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AT HOME SOLUTIONS, 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:
WALGREENS-OPTIONCARE
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:
1356366231
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/20/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3626 PAYSPHERE CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60674-0036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-879-6137
Provider Business Mailing Address Fax Number:
847-913-9024

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
682 S FERGUSON AVE
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
BOZEMAN
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59718-6490
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-587-1050
Provider Business Practice Location Address Fax Number:
406-587-1435
Provider Enumeration Date:
07/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ZSITEK
Authorized Official First Name:
LORI
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT & ASSISTANT SECRETAR
Authorized Official Telephone Number:
800-879-6137

Provider Taxonomy Codes

  • Taxonomy code: 261QI0500X , with the licence number:  1139 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X , with the licence number: 1139 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BP3500X , with the licence number: 1139 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X , with the licence number: 1139 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336H0001X , with the licence number: 1139 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0000380205 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 220558 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5606668 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1132121 01 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5603520 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".




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