1972562494 NPI number — EDGAR H. SANCHEZ, MD, INC.

Table of content: (NPI 1972562494)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972562494 NPI number — EDGAR H. SANCHEZ, MD, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EDGAR H. SANCHEZ, MD, 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:
STEUBENVILLE PULMONARY ASSOCIATES
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:
1972562494
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4100 JOHNSON RD
Provider Second Line Business Mailing Address:
SUITE 208
Provider Business Mailing Address City Name:
STEUBENVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43952-2356
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-264-7800
Provider Business Mailing Address Fax Number:
740-264-2334

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4100 JOHNSON RD
Provider Second Line Business Practice Location Address:
SUITE 208
Provider Business Practice Location Address City Name:
STEUBENVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43952-2356
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-264-7800
Provider Business Practice Location Address Fax Number:
740-264-2334
Provider Enumeration Date:
03/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SANCHEZ
Authorized Official First Name:
EDGAR
Authorized Official Middle Name:
H
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
740-264-7800

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X , with the licence number:  35065142S , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: DG4470 . This is a "RR MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0075820000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 27286850100 . This is a "BWC" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1460426 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0926798 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: DG4475 . This is a "RR MEDICARE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".




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