1063853620 NPI number — FAMILY & CHILDREN'S FIRST, INC

Table of content: (NPI 1063853620)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063853620 NPI number — FAMILY & CHILDREN'S FIRST, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY & CHILDREN'S FIRST, 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:
1063853620
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/25/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
525 ZANE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40203-3203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-893-3900
Provider Business Mailing Address Fax Number:
502-893-9646

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 W COURT AVE
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
JEFFERSONVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47130-3502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-893-3900
Provider Business Practice Location Address Fax Number:
502-893-9646
Provider Enumeration Date:
07/11/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MCQUADE
Authorized Official First Name:
JACK
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT - FINANCE
Authorized Official Telephone Number:
502-893-3900

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  06-0009 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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