1356630834 NPI number — FIRST PRIORITY HOME CARE SERVICES LLC

Table of content: MIGUEL R ARGUEDAS - BROLLO MD (NPI 1043267396)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356630834 NPI number — FIRST PRIORITY HOME CARE SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FIRST PRIORITY HOME CARE SERVICES LLC
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:
1356630834
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/02/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 EUCLID SQUARE MALL
Provider Second Line Business Mailing Address:
SUITE #216
Provider Business Mailing Address City Name:
EUCLID
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44132-2814
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-346-9256
Provider Business Mailing Address Fax Number:
866-611-9626

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 EUCLID SQUARE MALL
Provider Second Line Business Practice Location Address:
SUITE #216
Provider Business Practice Location Address City Name:
EUCLID
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-346-9256
Provider Business Practice Location Address Fax Number:
866-611-9626
Provider Enumeration Date:
04/05/2011

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
TAMEEKA
Authorized Official Middle Name:
DANYALE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
216-346-9256

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0057317 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com