1083685622 NPI number — COATESVILLE HOSPITAL CORPORATION

Table of content: (NPI 1083685622)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083685622 NPI number — COATESVILLE HOSPITAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COATESVILLE HOSPITAL CORPORATION
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:
BRANDYWINE HOSPITAL
Provider Other Organization Name Type Code:
3
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:
1083685622
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/13/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 503540
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63150-3540
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 REECEVILLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COATESVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19320-1542
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-383-8000
Provider Business Practice Location Address Fax Number:
610-383-8360
Provider Enumeration Date:
01/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LALOR
Authorized Official First Name:
PAULA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
DIRECTOR/DELEGATED OFFICIAL
Authorized Official Telephone Number:
615-925-4565

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  025801 , 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: 0001750000 . This is a "BC ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0071888101 . This is a "AMERICHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1007751290010 . This is a "COMMUNITY CARE BEHAVIORAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2518584 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0001750000 . This is a "HIGHMARK BC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0001750000 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0001750000 . This is a "BC CAPITAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 124571000 . This is a "MAGELLAN KHPE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 153185 . This is a "MAGELLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60064 . This is a "AMERIHEALTH MERCY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60064 . This is a "KEYSTONE MERCY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1007751290005 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0001750000 . This is a "AMERIHEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 08281 . This is a "HEALTH PARTNERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1007751290011 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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