1336141092 NPI number — NATIONAL HOME RESPIRATORY CARE OF NORTHEAST FLORIDA, INC.

Table of content: (NPI 1336141092)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336141092 NPI number — NATIONAL HOME RESPIRATORY CARE OF NORTHEAST FLORIDA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONAL HOME RESPIRATORY CARE OF NORTHEAST FLORIDA, 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:
1336141092
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1830 OAKLAND AVE STE 145
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDIANA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15701-3359
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-349-2868
Provider Business Mailing Address Fax Number:
724-349-2865

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1830 OAKLAND AVE STE 145
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIANA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15701-3359
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-349-2868
Provider Business Practice Location Address Fax Number:
724-349-2865
Provider Enumeration Date:
08/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
LESHER
Authorized Official First Name:
REBECCA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
724-349-2868

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  13 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 132861741 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000709959A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0257567-00 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 950036700 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00440496 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4581939 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7394624-00 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: DE2245 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0993758 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: DME00M584 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 009964075 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2044906 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7703775 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9115536 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100249728-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 12144100 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000709959B , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0324001 00 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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