1295032647 NPI number — COMMUNITY AND FAMILY SERVICES, INC.

Table of content: MRS. HANNAH BIANCA BULLINGER PA (NPI 1730603291)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295032647 NPI number — COMMUNITY AND FAMILY SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY AND FAMILY 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:
1295032647
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/22/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1087
Provider Second Line Business Mailing Address:
521 SOUTH WAYNE STREET
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47371-3187
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
260-726-9318
Provider Business Mailing Address Fax Number:
260-726-9174

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
521 S WAYNE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47371-2519
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
260-726-9318
Provider Business Practice Location Address Fax Number:
260-726-9174
Provider Enumeration Date:
02/22/2011

Additional Information

Authorized Official

Authorized Official Last Name:
VALIND
Authorized Official First Name:
JEFF
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
260-726-9318

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 100146820 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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