1144429291 NPI number — NEW PATHWAYS THERAPEUTIC SERVICES, INC.

Table of content: (NPI 1144429291)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144429291 NPI number — NEW PATHWAYS THERAPEUTIC SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW PATHWAYS THERAPEUTIC SERVICES, 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:
1144429291
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/17/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5120 GLENN DALE WOODS CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLENN DALE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20769-9114
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-577-7390
Provider Business Mailing Address Fax Number:
301-577-7392

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4200 FORBES BLVD STE 202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANHAM
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20706-4829
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-577-7390
Provider Business Practice Location Address Fax Number:
301-577-7392
Provider Enumeration Date:
07/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WILSON
Authorized Official First Name:
ELAINE
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
OWNER CEO
Authorized Official Telephone Number:
301-577-7390

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 407988400 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com