1447318662 NPI number — CHENANGO COUNTY CATHOLIC CHARITIES

Table of content: (NPI 1447318662)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447318662 NPI number — CHENANGO COUNTY CATHOLIC CHARITIES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHENANGO COUNTY CATHOLIC CHARITIES
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:
CATHOLIC CHARITIES OF CHENANGO COUNTY
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:
1447318662
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/07/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3 OHARA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORWICH
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13815-2046
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
607-334-8244
Provider Business Mailing Address Fax Number:
607-336-5779

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 OHARA DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORWICH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13815-2046
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-334-8244
Provider Business Practice Location Address Fax Number:
607-336-5779
Provider Enumeration Date:
12/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KING
Authorized Official First Name:
DEBORAH
Authorized Official Middle Name:
RANDALL
Authorized Official Title or Position:
FINANCE DIRECTOR
Authorized Official Telephone Number:
607-334-8244

Provider Taxonomy Codes

  • Taxonomy code: 251V00000X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM0850X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0855X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320800000X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 01303979 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200055623 . This is a "MOHAWK VALLEY PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 314554 . This is a "VALUE OPTIONS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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