1134566193 NPI number — UNITED METHODIST AGENCY FOR THE RETARDED WESTERN NORTH CAROLINA, INC

Table of content: (NPI 1134566193)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134566193 NPI number — UNITED METHODIST AGENCY FOR THE RETARDED WESTERN NORTH CAROLINA, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITED METHODIST AGENCY FOR THE RETARDED WESTERN NORTH CAROLINA, 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:
1134566193
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/31/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9800 KINCEY AVE
Provider Second Line Business Mailing Address:
PO BOX 1558
Provider Business Mailing Address City Name:
HUNTERSVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28078-8415
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-659-7636
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1025 E 36TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28205-1652
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-348-0994
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/31/2013

Additional Information

Authorized Official

Authorized Official Last Name:
CHURCH
Authorized Official First Name:
ANN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT AND CEO
Authorized Official Telephone Number:
704-659-7620

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X , with the licence number:  MHL0601044 , 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: 7802810 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7802987 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7803010 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7803215 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7803966 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7805458 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7802369 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7802744 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7804103 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7806020 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7802523 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7804012 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7806126 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7802200 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7802516 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7804104 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7804278 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3408796 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7802198 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7802643 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com