1679595540 NPI number — HEALTH SERVICES INC

Table of content: (NPI 1679595540)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679595540 NPI number — HEALTH SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH SERVICES 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:
6
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:
1679595540
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 70355
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONTGOMERY
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36107-0355
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-420-5038
Provider Business Mailing Address Fax Number:
334-420-0158

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8578 US HIGHWAY 80 W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TYLER
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36785-5417
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-872-1966
Provider Business Practice Location Address Fax Number:
334-872-0909
Provider Enumeration Date:
07/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WALDROP
Authorized Official First Name:
GEORGE
Authorized Official Middle Name:
R
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
334-420-5001

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 01D0967311 . This is a "CLIA" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 630004009 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com