1306611702 NPI number — HEPATITIS C TREATMENT CENTERS INC

Table of content: (NPI 1306611702)

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:
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 ; 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