1366496556 NPI number — ARIA HEALTH

Table of content: (NPI 1366496556)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366496556 NPI number — ARIA HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARIA HEALTH
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:
6
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:
1366496556
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/19/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9501 ROOSEVELT BLVD
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19114-1025
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-676-7393
Provider Business Mailing Address Fax Number:
215-676-1935

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9501 ROOSEVELT BLVD
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19114-1025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-676-7393
Provider Business Practice Location Address Fax Number:
215-676-1935
Provider Enumeration Date:
05/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
REINHOLT
Authorized Official First Name:
DENISE
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
215-676-7393

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  726505 , 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: 1007705250006 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 09582 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2984131 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0009460000 . This is a "KHPE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 9460 . This is a "IBC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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