1891780870 NPI number — FAMILY HEALTH COUNCIL OF CENTRAL PA, INC.

Table of content: (NPI 1891780870)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891780870 NPI number — FAMILY HEALTH COUNCIL OF CENTRAL PA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY HEALTH COUNCIL OF CENTRAL PA, 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:
CENTREHUNTINGDON TAPESTRY OF HEALTH
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:
1891780870
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/03/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
240 MATCH FACTORY PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLEFONTE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16823-1366
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-355-2762
Provider Business Mailing Address Fax Number:
814-355-8740

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
240 MATCH FACTORY PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLEFONTE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16823-1366
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-355-2762
Provider Business Practice Location Address Fax Number:
814-355-8740
Provider Enumeration Date:
09/15/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MUSSER
Authorized Official First Name:
KELLI
Authorized Official Middle Name:
L
Authorized Official Title or Position:
CLINIC ASSOCIATE
Authorized Official Telephone Number:
814-355-5472

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3000014 . This is a "KEYSTONE HEALTH PLAN CENT" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50018438 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: FM1634774 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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