1801862719 NPI number — 252 HEALTH CARE CONSULTANTS INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801862719 NPI number — 252 HEALTH CARE CONSULTANTS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
252 HEALTH CARE CONSULTANTS 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:
EMERALD POINTE HEALTH & REHAB CENTER
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:
1801862719
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/24/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 97
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GALENA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66739-0097
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
620-783-2755
Provider Business Mailing Address Fax Number:
620-783-5506

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
109 WEST EMPIRE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GALENA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66739-1013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-783-2755
Provider Business Practice Location Address Fax Number:
620-783-5506
Provider Enumeration Date:
02/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KEENER
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
BART
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
620-783-2755

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 314000000X , with the licence number: N011010 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 10445640A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100445640A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




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