1326463910 NPI number — THE BAIR FOUNDATION

Table of content: (NPI 1326463910)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326463910 NPI number — THE BAIR FOUNDATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE BAIR FOUNDATION
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:
1326463910
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/19/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
241 HIGH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW WILMINGTON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16142-1116
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:
2393 ALUMNI DR
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40517-4285
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-519-3273
Provider Business Practice Location Address Fax Number:
859-519-3274
Provider Enumeration Date:
02/19/2014

Additional Information

Authorized Official

Authorized Official Last Name:
MIKLOS
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
J
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
724-946-8711

Provider Taxonomy Codes

  • Taxonomy code: 253J00000X , with the licence number:  500632 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 253J00000X , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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