1629155072 NPI number — GORDON AND GORDON ENTERPRISES, INC.

Table of content: (NPI 1629155072)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629155072 NPI number — GORDON AND GORDON ENTERPRISES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GORDON AND GORDON ENTERPRISES, 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:
HOMEWATCH CAREGIVERS
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:
1629155072
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/09/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3864 ADLER PL
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
BETHLEHEM
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18017-9418
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-882-2477
Provider Business Mailing Address Fax Number:
610-882-0247

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3864 ADLER PL
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18017-9418
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-882-2477
Provider Business Practice Location Address Fax Number:
610-882-0247
Provider Enumeration Date:
11/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GORDON
Authorized Official First Name:
BELINDA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
610-882-2477

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0019385760002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0019385760001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0019385760008 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0019385760009 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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