1407041015 NPI number — BAFILE FAMILY CHIROPRACTIC

Table of content: (NPI 1407041015)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407041015 NPI number — BAFILE FAMILY CHIROPRACTIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BAFILE FAMILY CHIROPRACTIC
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:
1407041015
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/26/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
715 W BUTLER DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUGARLOAF
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18249-3003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-788-3737
Provider Business Mailing Address Fax Number:
570-788-3735

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
715 W BUTLER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUGARLOAF
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18249-3003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-788-3737
Provider Business Practice Location Address Fax Number:
570-788-3735
Provider Enumeration Date:
09/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BAFILE
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
VITO
Authorized Official Title or Position:
CHIROPRACTOR
Authorized Official Telephone Number:
570-788-3737

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC007795L , 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: N09492 . This is a "AMERIHEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 001994594 . This is a "BLUESHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 69677 . This is a "GEISINGER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7369295 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 822305 . This is a "1ST PRIORITY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000227822 . This is a "UNISON" identifier . This identifiers is of the category "OTHER".
  • Identifier: 11023859 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".
  • Identifier: BA1309492 . This is a "BLUESHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 002256301 . This is a "CAPITOL BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1032833 . This is a "ASHN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0018778550003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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