1114902137 NPI number — COMMUNITY HEALTH CARE INC.

Table of content: (NPI 1114902137)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114902137 NPI number — COMMUNITY HEALTH CARE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY HEALTH CARE 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:
1114902137
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/24/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1193 NORTON AVE
Provider Second Line Business Mailing Address:
STE. A
Provider Business Mailing Address City Name:
NORTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44203-9516
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-825-1152
Provider Business Mailing Address Fax Number:
330-825-9569

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
944 CHERRY ST E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CANAL FULTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44614-8669
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-854-4574
Provider Business Practice Location Address Fax Number:
330-854-0829
Provider Enumeration Date:
12/13/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ISON
Authorized Official First Name:
RODNEY
Authorized Official Middle Name:
K.
Authorized Official Title or Position:
CEO, PRESIDENT
Authorized Official Telephone Number:
330-854-4574

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: CK4119 . This is a "RAILROAD MEDICARE GROUP" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0827538 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2167211 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: CF0079 . This is a "RAILROAD MEDICARE GROUP" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0642479 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0683890 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2717822 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: CF1366 . This is a "MEDICARE RAILROAD GROUP" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0683194 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0842217 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2267658 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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