1487720819 NPI number — AMERICAN HEALTH CARE, INC.

Table of content: (NPI 1487720819)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487720819 NPI number — AMERICAN HEALTH CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICAN 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:
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:
1487720819
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/15/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
27 GLENDALE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UPPER DARBY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19082-2513
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-734-1666
Provider Business Mailing Address Fax Number:
610-734-1135

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
27 GLENDALE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UPPER DARBY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19082-2513
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-734-1666
Provider Business Practice Location Address Fax Number:
610-734-1135
Provider Enumeration Date:
11/28/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
VASUDEVAN
Authorized Official First Name:
NARAYAN
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
610-734-1666

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X , with the licence number:  3000006171 , 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: 0012800990002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0009111000 . This is a "BLUE CROSS, BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".