1396828646 NPI number — HOME MEDS INC

Table of content: (NPI 1396828646)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396828646 NPI number — HOME MEDS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOME MEDS 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:
1396828646
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1065 COLWELL LN STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CONSHOHOCKEN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19428-3205
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-832-7575
Provider Business Mailing Address Fax Number:
610-832-7578

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1065 COLWELL LN STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CONSHOHOCKEN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19428-3205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-832-7575
Provider Business Practice Location Address Fax Number:
610-832-7578
Provider Enumeration Date:
10/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ZWERKO
Authorized Official First Name:
MARGARET
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
610-832-7575

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  3000007148 , 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: 2653909 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 50010498 . This is a "PASSPORT HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 200891 . This is a "FEDERAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 629198 . This is a "TRIGON" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 200891 . This is a "BLUE CROSS BLUE SHIELD PA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 629198 . This is a "ANTHEM" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 010022312 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 90006933 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4582315 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




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