1053325951 NPI number — HCF OF WARREN, INC.

Table of content: (NPI 1053325951)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053325951 NPI number — HCF OF WARREN, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HCF OF WARREN, 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:
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:
1053325951
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1100 SHAWNEE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIMA
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45805-3583
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-999-2010
Provider Business Mailing Address Fax Number:
419-999-6284

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
682 PLEASANT DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WARREN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16365-3468
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-723-7060
Provider Business Practice Location Address Fax Number:
814-723-4544
Provider Enumeration Date:
07/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
UNVERFERTH
Authorized Official First Name:
CHAD
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
VICE PRESIDENT - FINANCE & CFO
Authorized Official Telephone Number:
419-999-2010

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  233202 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000099841 . This is a "THREE RIVERS/UNISON" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0019252370001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0034 . This is a "SECURITY BLUE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 00857410 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 305046 . This is a "ADVANTRA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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