1215396643 NPI number — HAMDEN HEALTH CARE VENTURES, INC

Table of content: (NPI 1215396643)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215396643 NPI number — HAMDEN HEALTH CARE VENTURES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAMDEN HEALTH CARE VENTURES, 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:
1215396643
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3546 DUNFEE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COOLVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45723-9722
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
38500 STATE ROUTE 160
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMDEN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45634-8805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-350-9095
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/12/2016

Additional Information

Authorized Official

Authorized Official Last Name:
CASEY
Authorized Official First Name:
BRYAN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
740-350-9095

Provider Taxonomy Codes

  • Taxonomy code: 314000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com