1891725768 NPI number — DHP INCORPORATED

Table of content: (NPI 1891725768)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891725768 NPI number — DHP INCORPORATED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DHP INCORPORATED
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:
DHP AMBULANCE SVC MAGOFFIN
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:
1891725768
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/26/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
171 ABBOTT CREEK RD STE 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PRESTONSBURG
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41653-8969
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-886-9845
Provider Business Mailing Address Fax Number:
606-886-0834

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1060 PARKWAY DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALYERSVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41465-1060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-349-5555
Provider Business Practice Location Address Fax Number:
606-886-0834
Provider Enumeration Date:
07/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FAIRLIE
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
314-489-8446

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  1670 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X , with the licence number: 1670 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 55001432 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 56030703 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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