1821148362 NPI number — MIDDLETON CHIROPRACTIC, INC.

Table of content: (NPI 1821148362)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821148362 NPI number — MIDDLETON CHIROPRACTIC, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MIDDLETON CHIROPRACTIC, 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:
1821148362
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/08/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
128 W CENTRAL AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TITUSVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16354-1726
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-827-9970
Provider Business Mailing Address Fax Number:
814-827-9971

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
128 W CENTRAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TITUSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16354-1726
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-827-9970
Provider Business Practice Location Address Fax Number:
814-827-9971
Provider Enumeration Date:
01/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MIDDLETON
Authorized Official First Name:
REBECCA
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
814-827-9970

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC007629L , 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: P00165689 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000861662 . This is a "BC BS MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 037618Q7V . This is a "MEDICARE ORIGINAL GROUP NUMBER BEFORE NPI" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1036231 . This is a "AMERICAN SPECIALTY HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0018122420003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: V0F118 . This is a "UPMC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 411278 . This is a "HEALTH ASSURANCE &AMERICA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 001346928 . This is a "BC BS #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0018122420002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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