1043380991 NPI number — KANE COUNTY HUMAN RESOURCE SPECIAL SERVICE DISTRICT

Table of content: (NPI 1043380991)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043380991 NPI number — KANE COUNTY HUMAN RESOURCE SPECIAL SERVICE DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KANE COUNTY HUMAN RESOURCE SPECIAL SERVICE DISTRICT
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:
Provider Other Organization Name Type Code:
6
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:
1043380991
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/10/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
355 N MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KANAB
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84741-3260
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
435-644-5811
Provider Business Mailing Address Fax Number:
435-644-3588

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
355 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANAB
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84741-3260
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-644-5811
Provider Business Practice Location Address Fax Number:
435-644-3588
Provider Enumeration Date:
11/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PANDYA
Authorized Official First Name:
SHERRIE
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
435-644-5811

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  2005-HOSP-425 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1852 . This is a "PUBLIC EMPLOYEES HEALTH P" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 860096778048 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 033359299 . This is a "OWCP" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 876000300009 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 87600030003 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 36832 . This is a "DESERET MUTUAL BENEFIT AS" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 020636 . This is a "AHCCCS" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 103000790101 . This is a "SELECT HEALTH" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com