1528151701 NPI number — GSH HOME MED CARE LLC

Table of content: (NPI 1528151701)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528151701 NPI number — GSH HOME MED CARE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GSH HOME MED CARE 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:
WELLSPAN MEDICAL EQUIPMENT
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:
1528151701
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/06/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
785 5TH AVE STE 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHAMBERSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17201-4232
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-263-9555
Provider Business Mailing Address Fax Number:
717-335-2332

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1081 SHARP AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EPHRATA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17522-1135
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-721-4299
Provider Business Practice Location Address Fax Number:
717-733-4302
Provider Enumeration Date:
10/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ZIMMERMAN
Authorized Official First Name:
ROY
Authorized Official Middle Name:
Authorized Official Title or Position:
SR DIRECTOR
Authorized Official Telephone Number:
717-639-2664

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , 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: 1519615 . This is a "GATEWAY HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0039289000 . This is a "PERSONAL CHOICE PPO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1000856 . This is a "AMERIHEALTH MERCI" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007464680120 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 39HA37 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 217220 . This is a "HEALTH AMERICA/ASSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0533068 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000124064 . This is a "UNISON HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 207557 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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