1356564330 NPI number — MICHAEL FERRANCE CHIROPRACTIC

Table of content: (NPI 1356564330)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356564330 NPI number — MICHAEL FERRANCE CHIROPRACTIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MICHAEL FERRANCE CHIROPRACTIC
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:
1356564330
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/22/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
213 ROSE STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IRVONA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16656
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-672-3333
Provider Business Mailing Address Fax Number:
814-672-3119

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
213 ROSE STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IRVONA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16656
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-672-3333
Provider Business Practice Location Address Fax Number:
814-672-3119
Provider Enumeration Date:
04/10/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FERRANCE
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIROPRACTIC
Authorized Official Telephone Number:
814-672-3333

Provider Taxonomy Codes

  • Taxonomy code: 111NR0200X , with the licence number:  DC007727L , 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: 001317378 . This is a "BCBS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 001798850 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 350049240 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".