1679060420 NPI number — PARTNERSHIP OF AFRICAN AMERICAN CHURCHES INC.

Table of content: ANITA MARIE THOMPSON PTA (NPI 1760296065)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679060420 NPI number — PARTNERSHIP OF AFRICAN AMERICAN CHURCHES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PARTNERSHIP OF AFRICAN AMERICAN CHURCHES 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:
Provider Other Organization Name Type Code:
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:
1679060420
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/19/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 452
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INSTITUTE
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25112-0452
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-768-7688
Provider Business Mailing Address Fax Number:
304-768-7647

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1514 KANAWHA BLVD W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLESTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25387-2533
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-768-7688
Provider Business Practice Location Address Fax Number:
304-768-7647
Provider Enumeration Date:
04/17/2018

Additional Information

Authorized Official

Authorized Official Last Name:
GREEN
Authorized Official First Name:
EDNA
Authorized Official Middle Name:
Authorized Official Title or Position:
ASSOCIATE DIRECTOR OPERATIONS
Authorized Official Telephone Number:
304-768-7688

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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