1659385797 NPI number — HCF OF FAIRVIEW, INC.

Table of content: (NPI 1659385797)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659385797 NPI number — HCF OF FAIRVIEW, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HCF OF FAIRVIEW, 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:
FAIRVIEW MANOR
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:
1659385797
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/16/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
900 MANCHESTER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAIRVIEW
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16415-1703
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-838-4822
Provider Business Mailing Address Fax Number:
814-833-8536

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 MANCHESTER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRVIEW
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16415-1703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-838-4822
Provider Business Practice Location Address Fax Number:
814-833-8536
Provider Enumeration Date:
07/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
STECHSCHULTE
Authorized Official First Name:
RYAN
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR - CORPORATE COMPLIANCE
Authorized Official Telephone Number:
419-999-2010

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  320802 , 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: 0988 . This is a "SECURITY BLUE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0019251570001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000099547 . This is a "THREE RIVERS/UNISON" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 275110 . This is a "ADVANTRA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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