1922540442 NPI number — HORIZON HEALTH CARE SERVICES INC

Table of content: (NPI 1922540442)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922540442 NPI number — HORIZON HEALTH CARE SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HORIZON HEALTH CARE SERVICES 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:
NATIONAL DME SUPPLY
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:
1922540442
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1357 BRICKYARD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHIPLEY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32428-2467
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-776-8400
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
335 S SAINT ANDREWS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOTHAN
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36301-2675
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-776-8400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/15/2016

Additional Information

Authorized Official

Authorized Official Last Name:
AFFENITA
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
PETER
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
877-776-8400

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X , with the licence number:  236 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X , with the licence number: 838 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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