1811214232 NPI number — CHIROPRACTIC HEALTHCARE, LLC

Table of content: (NPI 1811214232)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811214232 NPI number — CHIROPRACTIC HEALTHCARE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHIROPRACTIC HEALTHCARE, LLC
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:
1811214232
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
214 ENCLAVE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW CASTLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16105-3223
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-498-4401
Provider Business Mailing Address Fax Number:
724-498-4770

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
214 ENCLAVE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16105-3223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-498-4401
Provider Business Practice Location Address Fax Number:
724-498-4770
Provider Enumeration Date:
04/24/2010

Additional Information

Authorized Official

Authorized Official Last Name:
SIMARI-PAPOTTO
Authorized Official First Name:
DEBRA
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIROPRACTOR/SOLE PROPRIETOR
Authorized Official Telephone Number:
724-498-4401

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC005647-L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 152885 . This is a "MED PLUS/THREE RIVERS HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 251614117 . This is a "DEVON" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 8191631 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 42211/152885 . This is a "UNISON" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 7160666 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1027804 . This is a "AMERICAN SPECIALTY HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 682212 . This is a "ACN GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 682212 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 182799 . This is a "MEDICARE PTAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1306143 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 5719468 . This is a "COVENTRY/FIRST HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com