1700857661 NPI number — FAMILY HOME HEALTH CARE PRODUCTS INC

Table of content: (NPI 1700857661)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700857661 NPI number — FAMILY HOME HEALTH CARE PRODUCTS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY HOME HEALTH CARE PRODUCTS 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:
FAMILY HOME MEDICAL
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:
1700857661
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 SPRINT DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARLISLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17015-7696
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-249-8051
Provider Business Mailing Address Fax Number:
717-243-9423

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 SPRINT DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARLISLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17015-7696
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-249-8051
Provider Business Practice Location Address Fax Number:
717-243-9423
Provider Enumeration Date:
01/30/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BURKHOLDER
Authorized Official First Name:
STEVE
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
717-249-8051

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  81027527 , 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: 0017315290004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".