1104263300 NPI number — SALUS HOME HEALTH SOLUTIONS, LLC

Table of content: (NPI 1104263300)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104263300 NPI number — SALUS HOME HEALTH SOLUTIONS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SALUS HOME HEALTH SOLUTIONS, LLC
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:
1104263300
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/09/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 860313
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLANO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75086-0313
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-249-7234
Provider Business Mailing Address Fax Number:
214-291-5474

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1680 ASHCROFT DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRVIEW
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75069-1919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-249-7234
Provider Business Practice Location Address Fax Number:
214-291-5474
Provider Enumeration Date:
05/28/2013

Additional Information

Authorized Official

Authorized Official Last Name:
IRWIN
Authorized Official First Name:
LARRY
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
972-249-7234

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com