1174637078 NPI number — CHV HOME MEDICAL EQUIPMENT COMPANY, LLC

Table of content: JASON ROBERT WOODS MS (NPI 1427993716)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174637078 NPI number — CHV HOME MEDICAL EQUIPMENT COMPANY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHV HOME MEDICAL EQUIPMENT COMPANY, LLC
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:
1174637078
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/25/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 HOME CARE PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AKRON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44320-3901
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-745-1601
Provider Business Mailing Address Fax Number:
330-848-6216

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
155 LINCOLN WAY W
Provider Second Line Business Practice Location Address:
A-96 SUITE 1
Provider Business Practice Location Address City Name:
MASSILLON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44647-6583
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-837-6873
Provider Business Practice Location Address Fax Number:
330-434-6550
Provider Enumeration Date:
08/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MULLEN
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT AGHS VNSA
Authorized Official Telephone Number:
330-848-6203

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  77190692 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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