1720115298 NPI number — ALLEN COUNTY COUNTY TREASURER

Table of content: (NPI 1720115298)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720115298 NPI number — ALLEN COUNTY COUNTY TREASURER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLEN COUNTY COUNTY TREASURER
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:
1720115298
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/20/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 589
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MADISONVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42431-5011
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-824-8123
Provider Business Mailing Address Fax Number:
270-237-5973

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 LEX CARTER CIR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCOTTSVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42164-7604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-237-4938
Provider Business Practice Location Address Fax Number:
270-237-5973
Provider Enumeration Date:
02/28/2007

Additional Information

Authorized Official

Authorized Official Last Name:
TAYLOR
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
ED
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
270-237-4938

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  001414 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 56003361 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 590013366 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1720115298 . This is a "WELLCARE - MEDICAID MCO" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1720115298 . This is a "COVENTRY CARE - MEDICAID MCO" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000640246 . This is a "ANTHEM / BCBS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 55002034 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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