1427559020 NPI number — KPW HEALTH LLC

Table of content: (NPI 1427559020)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427559020 NPI number — KPW HEALTH LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KPW HEALTH 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:
1427559020
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
603 7TH ST S STE 540
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ST PETERSBURG
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33701-4734
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-230-3423
Provider Business Mailing Address Fax Number:
217-636-3056

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
603 7TH ST S STE 540
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST PETERSBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33701-4734
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-230-3423
Provider Business Practice Location Address Fax Number:
217-636-3056
Provider Enumeration Date:
02/28/2018

Additional Information

Authorized Official

Authorized Official Last Name:
WESTON
Authorized Official First Name:
KHALILAH
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
734-657-5407

Provider Taxonomy Codes

  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 06111 . This is a "OXFORD HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 14163 . This is a "WELLCARE FLORIDA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 62308 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 80214 . This is a "CHAMPVA" identifier . This identifiers is of the category "OTHER".
  • Identifier: MC010 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: WELLM2 . This is a "WELLMED/UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 13551 . This is a "GHI/EMBLEM HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 20133 . This is a "OPTIMUM INSURANCE PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 61101 . This is a "HUMANA, INC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 64157 . This is a "MERITAIN HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 36273 . This is a "AARP- UHC OVATIONS INSURANCE SOLUTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60054 . This is a "AETNA MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 14163 . This is a "STAYWELL HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 28804 . This is a "AMERIGROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60054 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 62308 . This is a "GREAT WEST PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 68069 . This is a "SUNSHINE MEDICAID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 77003 . This is a "PRESTIGE" identifier . This identifiers is of the category "OTHER".
  • Identifier: BS022 . This is a "BLUE SHIELD FLORIDA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 44054 . This is a "GEHA" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com