1306611702 NPI number — HEPATITIS C TREATMENT CENTERS INC

Table of content: CAMEISHA AILEAN MERRIWEATHER LCSW (NPI 1922317767)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306611702 NPI number — HEPATITIS C TREATMENT CENTERS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEPATITIS C TREATMENT CENTERS 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:
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:
1306611702
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/06/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1009A N DUPONT SQ
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40207-4612
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-894-9950
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
213 U S HIGHWAY 250
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ADENA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43901-7925
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-894-9950
Provider Business Practice Location Address Fax Number:
502-894-9991
Provider Enumeration Date:
11/16/2023

Additional Information

Authorized Official

Authorized Official Last Name:
BOND
Authorized Official First Name:
LORI
Authorized Official Middle Name:
DIANE
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
502-894-9950

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , registered in the state of NULL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2026 www.npivalidator.com