1740289735 NPI number — BEST BUY HOMECARE OF LOUISIANA, INC

Table of content: (NPI 1740289735)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740289735 NPI number — BEST BUY HOMECARE OF LOUISIANA, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEST BUY HOMECARE OF LOUISIANA, 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:
BEST BUY HOMECARE
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:
1740289735
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 SCHUMATE CHAPEL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JEFFERSON CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65109-0583
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-634-6001
Provider Business Mailing Address Fax Number:
573-634-2816

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 SCHUMATE CHAPEL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JEFFERSON CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65109-0583
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-634-6001
Provider Business Practice Location Address Fax Number:
573-634-2816
Provider Enumeration Date:
07/20/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MCKENNA
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
S
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
573-754-4527

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 81714 . This is a "NORTHWOOD (NPN)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 82-05005 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: V0167 . This is a "HOMELINK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 106481 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 228220 . This is a "HEALTHLINK" identifier . This identifiers is of the category "OTHER".