1366731184 NPI number — HOME HEALTH CONNECTION, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366731184 NPI number — HOME HEALTH CONNECTION, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOME HEALTH CONNECTION, 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:
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:
1366731184
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/13/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 31105
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BETHESDA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20824-1105
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-718-0112
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 E PRATT ST
Provider Second Line Business Practice Location Address:
SUITE 832
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21202-3116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-525-9300
Provider Business Practice Location Address Fax Number:
410-525-0596
Provider Enumeration Date:
04/01/2011

Additional Information

Authorized Official

Authorized Official Last Name:
MAFI
Authorized Official First Name:
SHAHIN
Authorized Official Middle Name:
D
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
301-718-0112

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  R1136 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 4081145-01 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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