1356509962 NPI number — CUMBERLAND VALLEY SPECIALTY SERVICES

Table of content: (NPI 1356509962)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356509962 NPI number — CUMBERLAND VALLEY SPECIALTY SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CUMBERLAND VALLEY SPECIALTY 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:
ANN-MARIE N HUGH MD
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:
1356509962
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
120 N 7TH ST
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
CHAMBERSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17201-1795
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-217-4229
Provider Business Mailing Address Fax Number:
717-263-6255

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
757 NORLAND AVE
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
CHAMBERSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17201-4230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-217-6970
Provider Business Practice Location Address Fax Number:
717-217-6792
Provider Enumeration Date:
05/30/2008

Additional Information

Authorized Official

Authorized Official Last Name:
HOBBS
Authorized Official First Name:
AMY
Authorized Official Middle Name:
C
Authorized Official Title or Position:
BILLING & COLLECTIONS ADMINISTRATOR
Authorized Official Telephone Number:
717-217-4229

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  MD432720 , 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: 1020422540001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com