1396774287 NPI number — PRIORITY HOME HEALTH CARE, INC

Table of content: MR. CHAD E. OLSZEWSKI P.C. (NPI 1275780801)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396774287 NPI number — PRIORITY HOME HEALTH CARE, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRIORITY HOME HEALTH CARE, 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:
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:
1396774287
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/09/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2300 WARRENVILLE RD STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DOWNERS GROVE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60515-1717
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-296-3591
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
291 N CLEVELAND MASSILLON RD STE 203
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AKRON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44333-4513
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-869-9520
Provider Business Practice Location Address Fax Number:
330-869-9524
Provider Enumeration Date:
07/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ANDERSON
Authorized Official First Name:
DARBY
Authorized Official Middle Name:
Authorized Official Title or Position:
EVP CHIEF STRATEGY OFFICER
Authorized Official Telephone Number:
630-296-3400

Provider Taxonomy Codes

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

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

  • Identifier: 0372609 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0849327 . This is a "MEDICAID DISAB & MED FRAG" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1801027 . This is a "OHIO MRDD I-O WAIVER" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 497783 . This is a "OH DEPT OF AGING" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 55-1818531 . This is a "PDA WAIVER PROGRAM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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