1770701146 NPI number — HEALTH CARE CONNECTIONS, INC

Table of content: (NPI 1770701146)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770701146 NPI number — HEALTH CARE CONNECTIONS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH CARE CONNECTIONS, 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:
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:
1770701146
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/07/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
402 S MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RAEFORD
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28376-3223
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-875-1032
Provider Business Mailing Address Fax Number:
910-875-1149

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
402 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RAEFORD
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28376-3223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-875-1032
Provider Business Practice Location Address Fax Number:
910-875-1149
Provider Enumeration Date:
04/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HARRIS
Authorized Official First Name:
KASHEMA
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
910-875-1032

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HC2495 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: HC2459 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: HC2261 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251E00000X , with the licence number: HC2350 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: HC2260 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: HC2259 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: HC2852 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: HC3186 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: HC3036 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: HC2850 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 6601029 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6600800 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6601287 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6601307 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6600915 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6601289 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6601121 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3409375 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6600920 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6601141 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6601286 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6600910 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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