1831283985 NPI number — COLUMBIA COUNTY DEPARTMENT OF HEALTH

Table of content: (NPI 1831283985)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831283985 NPI number — COLUMBIA COUNTY DEPARTMENT OF HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COLUMBIA COUNTY DEPARTMENT OF HEALTH
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:
EARLY INTERVENTION AND PRESCHOOL SERVICES PROGRAM
Provider Other Organization Name Type Code:
5
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:
1831283985
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/29/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
325 COLUMBIA ST
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
HUDSON
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12534-1902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-828-4278
Provider Business Mailing Address Fax Number:
518-671-6738

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
325 COLUMBIA ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
HUDSON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12534-1902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-828-4278
Provider Business Practice Location Address Fax Number:
518-671-6738
Provider Enumeration Date:
10/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PAPADAKIS
Authorized Official First Name:
ANNA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
518-828-4278

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 252Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 0041968 . This is a "GROUP HEALTH INC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000499404001 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 03003752 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000499404001 . This is a "BLUE SHIELD NENY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 13641 . This is a "GHI HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10002521 . This is a "CAPITAL DISTRICT PHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 004569 . This is a "EMPIRE BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00473258 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2301493 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 986047 . This is a "MVP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 040401000513 . This is a "FIDELIS CARE OF NY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 113641 . This is a "WELLCARE" identifier . This identifiers is of the category "OTHER".




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