1295764843 NPI number — HOSPITAL CARE SPECIALIST LLC

Table of content: (NPI 1295764843)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295764843 NPI number — HOSPITAL CARE SPECIALIST LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOSPITAL CARE SPECIALIST 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:
1295764843
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/10/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 427
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEDERACH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19450-0427
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-528-0006
Provider Business Mailing Address Fax Number:
732-349-6030

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
835 W CHESTER PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST CHESTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19382-4863
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-528-0006
Provider Business Practice Location Address Fax Number:
732-349-6030
Provider Enumeration Date:
07/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KHAN
Authorized Official First Name:
SHABIH
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
610-738-2545

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0019195250001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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