1164404950 NPI number — HACKLEY VISITING NURSE SERVICES AND HOSPICE INC

Table of content: (NPI 1164404950)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164404950 NPI number — HACKLEY VISITING NURSE SERVICES AND HOSPICE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HACKLEY VISITING NURSE SERVICES AND HOSPICE 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:
1164404950
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/05/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
888 TERRACE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MUSKEGON
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49440-1220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
231-726-5025
Provider Business Mailing Address Fax Number:
231-728-4958

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
888 TERRACE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MUSKEGON
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49440-1220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
231-726-5025
Provider Business Practice Location Address Fax Number:
231-728-4958
Provider Enumeration Date:
11/17/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BISHOP
Authorized Official First Name:
ERIN
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF PATIENT ACCOUNTING
Authorized Official Telephone Number:
734-542-8213

Provider Taxonomy Codes

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

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

  • Identifier: 0E026 . This is a "BLUE CROSS & BLUE SHIELD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 30937 . This is a "HEALTH PLAN OF MICHIGAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 5173758 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0E026 . This is a "BLUE CHOICE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0E026 . This is a "BLUE CARE NETWORK" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 800000029 . This is a "PRIORITY HEALTH" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com