1477521771 NPI number — ARCADIAN HEALTHCARE INC

Table of content: (NPI 1477521771)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477521771 NPI number — ARCADIAN HEALTHCARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARCADIAN HEALTHCARE 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:
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:
1477521771
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 867
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PINE BROOK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07058-0867
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-637-4423
Provider Business Mailing Address Fax Number:
973-575-0512

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
45 US HIGHWAY 46 EAST
Provider Second Line Business Practice Location Address:
UNIT 606
Provider Business Practice Location Address City Name:
PINE BROOK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07058
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-637-4423
Provider Business Practice Location Address Fax Number:
973-575-0512
Provider Enumeration Date:
03/10/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CARLBERG
Authorized Official First Name:
DONALD
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
800-637-4423

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 10000017142 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02442006 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0019296570003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0001287 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".