1386776540 NPI number — A&S HOME HEALTHCARE, INC.

Table of content: (NPI 1386776540)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386776540 NPI number — A&S HOME HEALTHCARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A&S HOME HEALTHCARE, 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:
1386776540
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/05/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6900 MAIN ST
Provider Second Line Business Mailing Address:
SUITE# 200
Provider Business Mailing Address City Name:
DOWNERS GROVE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60516-3454
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-964-6100
Provider Business Mailing Address Fax Number:
630-964-6440

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6900 MAIN ST
Provider Second Line Business Practice Location Address:
SUITE# 200
Provider Business Practice Location Address City Name:
DOWNERS GROVE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60516-3454
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-964-6100
Provider Business Practice Location Address Fax Number:
630-964-6440
Provider Enumeration Date:
03/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SURTI
Authorized Official First Name:
SULTAN
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
630-964-6100

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  IL1010705 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: IL1010705 . This is a "STATE LICENCE NUMBER" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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