1366440968 NPI number — HEALTH SYSTEM SERVICES, LTD.

Table of Contents

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: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • 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" .

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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