1467455220 NPI number — COUNTY OF WASHINGTON

Table of content: (NPI 1467455220)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467455220 NPI number — COUNTY OF WASHINGTON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF WASHINGTON
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:
WASHINGTON COUNTY HEALTH CENTER
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:
1467455220
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
36 OLD HICKORY RIDGE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15301-8613
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-228-5010
Provider Business Mailing Address Fax Number:
724-223-7187

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
36 OLD HICKORY RIDGE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301-8613
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-228-5010
Provider Business Practice Location Address Fax Number:
724-223-7187
Provider Enumeration Date:
05/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SNYDER
Authorized Official First Name:
LYNN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
FISCAL DIRECTOR
Authorized Official Telephone Number:
724-228-5010

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  751102 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1002272960004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1296031 . This is a "UMWA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0561 . This is a "BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1502821 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 90851 . This is a "THREE RIVERS MED PLUS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 53252 . This is a "ADVANTRA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: V0023A . This is a "UPMC FOR YOU" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 100227960004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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