1588793145 NPI number — THE SALVATION ARMY

Table of content: (NPI 1588793145)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588793145 NPI number — THE SALVATION ARMY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE SALVATION ARMY
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:
THE SALVATION ARMY HARBOR LIGHT COMPLEX
Provider Other Organization Name Type Code:
5
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:
1588793145
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/15/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
440 WEST NYACK ROAD
Provider Second Line Business Mailing Address:
PO BOX C-635
Provider Business Mailing Address City Name:
WEST NYACK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10994-1739
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-620-7200
Provider Business Mailing Address Fax Number:
845-620-7615

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
865 W NORTH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15233-1616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-231-0500
Provider Business Practice Location Address Fax Number:
412-231-7809
Provider Enumeration Date:
03/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SOUTHWICK
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
JOHN
Authorized Official Title or Position:
SECRETARY
Authorized Official Telephone Number:
845-620-7329

Provider Taxonomy Codes

  • Taxonomy code: 324500000X , with the licence number:  770450 , 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)





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