1073558672 NPI number — COMMUNITY CAREPARTNERS, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073558672 NPI number — COMMUNITY CAREPARTNERS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY CAREPARTNERS, 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:
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:
1073558672
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/11/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
68 SWEETEN CREEK ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28803-2318
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-277-4800
Provider Business Mailing Address Fax Number:
828-277-4865

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
68 SWEETEN CREEK ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-277-4800
Provider Business Practice Location Address Fax Number:
828-277-4865
Provider Enumeration Date:
06/18/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BUCHANAN
Authorized Official First Name:
TRACY
Authorized Official Middle Name:
T
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
828-277-4800

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LG0600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 283X00000X , with the licence number: H0081 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00034 . This is a "BLUE CROSS PROVIDER #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 50-706-59 . This is a "UHC PROVIDER #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3403025 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".