1164511093 NPI number — ADAMS COUNTY COUNCIL ON DRUG & ALCOHOL ABUSE

Table of content: (NPI 1164511093)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164511093 NPI number — ADAMS COUNTY COUNCIL ON DRUG & ALCOHOL ABUSE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADAMS COUNTY COUNCIL ON DRUG & ALCOHOL ABUSE
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:
1164511093
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/30/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 FREDERICK ST
Provider Second Line Business Mailing Address:
SUITE 3
Provider Business Mailing Address City Name:
HANOVER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17331-3709
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-632-6555
Provider Business Mailing Address Fax Number:
717-632-5434

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 FREDERICK ST
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
HANOVER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17331-3709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-632-6555
Provider Business Practice Location Address Fax Number:
717-632-5434
Provider Enumeration Date:
10/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SPONSELLER
Authorized Official First Name:
DIANE
Authorized Official Middle Name:
R
Authorized Official Title or Position:
BILLING/OFFICE MANAGER
Authorized Official Telephone Number:
717-632-6555

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  677035 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1007311330009 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com