1548251366 NPI number — CHATTAHOOCHEE VALLEY HOSPITAL SOCIETY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548251366 NPI number — CHATTAHOOCHEE VALLEY HOSPITAL SOCIETY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHATTAHOOCHEE VALLEY HOSPITAL SOCIETY
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:
6
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:
1548251366
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/11/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 348
Provider Second Line Business Mailing Address:
4800 48TH ST
Provider Business Mailing Address City Name:
VALLEY
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36854-3666
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-756-1648
Provider Business Mailing Address Fax Number:
334-756-5874

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4800 48TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VALLEY
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36854-3666
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-756-1648
Provider Business Practice Location Address Fax Number:
334-756-5874
Provider Enumeration Date:
11/01/2005

Additional Information

Authorized Official

Authorized Official Last Name:
OPRANDY
Authorized Official First Name:
FRANK
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
334-756-1495

Provider Taxonomy Codes

  • Taxonomy code: 275N00000X , with the licence number:  001809 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: O1U025 . This is a "MEDICARE SW BED PROV NUM" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 010076 . This is a "BCBS HOSP PROV #" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: HOS0025H , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




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