1730314246 NPI number — MRS. ANGELINA ANNETTE HAMBY STNA

Table of content: MRS. ANGELINA ANNETTE HAMBY STNA (NPI 1730314246)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730314246 NPI number — MRS. ANGELINA ANNETTE HAMBY STNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAMBY
Provider First Name:
ANGELINA
Provider Middle Name:
ANNETTE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
STNA
Provider Gender Code:
F

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:
1730314246
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/28/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1023 LONDON GROVEPORT RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GROVE CITY
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43123-8971
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-875-5926
Provider Business Mailing Address Fax Number:
614-875-5926

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3100 LONGRIDGE WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GROVE CITY
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43123-9772
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-801-1166
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/28/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 376K00000X , with the licence number:  400546851006 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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