1376521104 NPI number — FRIENDSHIP HOME HEALTH 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 1376521104 NPI number — FRIENDSHIP HOME HEALTH INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRIENDSHIP HOME HEALTH 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:
FRIENDSHIP HOME MEDICAL EQUIPMENT INC
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:
1376521104
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2410
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WISE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24293
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
276-328-2500
Provider Business Mailing Address Fax Number:
276-328-3117

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
513 CHERRY STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLUEFIELD
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
24701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-323-4000
Provider Business Practice Location Address Fax Number:
304-324-8981
Provider Enumeration Date:
01/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FREEMAN
Authorized Official First Name:
RONALD
Authorized Official Middle Name:
K
Authorized Official Title or Position:
OWNER/PRESIDENT
Authorized Official Telephone Number:
276-328-2500

Provider Taxonomy Codes

  • Taxonomy code: 332BP3500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 332BX2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 4649846 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 147029 . This is a "BCBS ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 0147422000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 64477 . This is a "ABP ADMINISTRATION" identifier . This identifiers is of the category "OTHER".
  • Identifier: 80525 . This is a "NORTHWOOD NPN" identifier . This identifiers is of the category "OTHER".




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