1588624332 NPI number — ADAMS HEALTH CARE CENTER

Table of content: (NPI 1588624332)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588624332 NPI number — ADAMS HEALTH CARE CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADAMS HEALTH CARE CENTER
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:
ADAMS HOME HEALTH AGENCY
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:
1588624332
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/13/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
810 W MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ADAMS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55909-9764
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-582-3601
Provider Business Mailing Address Fax Number:
507-582-3589

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
810 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ADAMS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55909-9764
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-582-3601
Provider Business Practice Location Address Fax Number:
507-582-3589
Provider Enumeration Date:
03/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KIEFER
Authorized Official First Name:
KRISTA
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
BILLING AGENT
Authorized Official Telephone Number:
507-582-3601

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  346639 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 364355700 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 070527001 . This is a "METROPOLITAN HEALTH PLAN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 141970 . This is a "UCARE OF MINNESOTA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 3J94AD . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 92460 . This is a "MAYO MANAGEMENT SERVICES" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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