1730227307 NPI number — MULTI-CULTURAL HEALTH EVALUATION DELIVERY SYSTEMS INC

Table of content: (NPI 1730227307)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730227307 NPI number — MULTI-CULTURAL HEALTH EVALUATION DELIVERY SYSTEMS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MULTI-CULTURAL HEALTH EVALUATION DELIVERY SYSTEMS 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:
MHEDS
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:
1730227307
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/02/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2928 PEACH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ERIE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16508-1843
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-453-6229
Provider Business Mailing Address Fax Number:
814-456-3731

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2928 PEACH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ERIE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16508-1843
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-453-6229
Provider Business Practice Location Address Fax Number:
814-456-3731
Provider Enumeration Date:
02/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
STUBBER
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
J
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
814-453-6229

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: 0011041350002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1026455800002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0011041350006 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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