1366440968 NPI number — HEALTH SYSTEM SERVICES, LTD.

Table of content: (NPI 1366440968)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366440968 NPI number — HEALTH SYSTEM SERVICES, LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH SYSTEM SERVICES, LTD.
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:
1366440968
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/14/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6867 WILLIAMS ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NIAGARA FALLS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14304
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-283-2339
Provider Business Mailing Address Fax Number:
716-283-1291

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6867 WILLIAMS ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NIAGARA FALLS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-283-2339
Provider Business Practice Location Address Fax Number:
716-283-1291
Provider Enumeration Date:
07/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MINICUCCI
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
716-283-2339

Provider Taxonomy Codes

  • Taxonomy code: 332BN1400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BP3500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 003108017 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8290363 . This is a "INDEPENDENT HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 010274664 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 892227 . This is a "MVP HEALTH CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 009957245 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02910323 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1007638 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1021043100001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02118734 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 04178569 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 115217GD . This is a "PREFERRED CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4582320 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000551199001 . This is a "BCBS OF WESTERN NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000551199002 . This is a "BCBS OF NORTHEASTERN NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3400125 . This is a "GHI - GROUP HEALTH INCORP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00011260701 . This is a "UNIVERA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 808655549A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




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