1346270022 NPI number — THREE RIVERS HOME HEALTH SERVICES, INC.

Table of content: FRANCES ANDREA THOMAS NP (NPI 1417679200)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346270022 NPI number — THREE RIVERS HOME HEALTH SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THREE RIVERS HOME HEALTH SERVICES, 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:
1346270022
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/11/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 640
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EASTMAN
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31023-0640
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
478-374-3468
Provider Business Mailing Address Fax Number:
478-374-6741

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1760 BASS RD
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
MACON
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31210-1061
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
478-405-1474
Provider Business Practice Location Address Fax Number:
478-405-1476
Provider Enumeration Date:
07/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
HAL
Authorized Official Middle Name:
M
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
478-374-3468

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  011-267-H , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00821026B , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




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