1346314242 NPI number — MIHALKO CHIROPRACTIC PC

Table of content: (NPI 1346314242)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346314242 NPI number — MIHALKO CHIROPRACTIC PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MIHALKO CHIROPRACTIC PC
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:
1346314242
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
217 FRANKLIN AVENUE
Provider Second Line Business Mailing Address:
SUITE 6
Provider Business Mailing Address City Name:
PALMERTON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18071
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-826-4136
Provider Business Mailing Address Fax Number:
610-824-6515

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
217 FRANKLIN AVENUE
Provider Second Line Business Practice Location Address:
SUITE 6
Provider Business Practice Location Address City Name:
PALMERTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18071
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-826-4136
Provider Business Practice Location Address Fax Number:
610-824-6515
Provider Enumeration Date:
11/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MIHALKO
Authorized Official First Name:
STACEY
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
610-826-4136

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC007606L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1786509 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 753161 . This is a "CAP BC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 753161 . This is a "BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com