1417449471 NPI number — SIGNAL HEALTH GROUP MEDICAL HHA INC

Table of content: DR. NYABILONDI HUGUETTE EBAMA M.D. (NPI 1467618900)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417449471 NPI number — SIGNAL HEALTH GROUP MEDICAL HHA INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SIGNAL HEALTH GROUP MEDICAL HHA 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:
1417449471
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/03/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 17460
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDIANAPOLIS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46217-0460
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-260-6145
Provider Business Mailing Address Fax Number:
888-681-9011

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10500 CROSSPOINT BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46256
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-260-6145
Provider Business Practice Location Address Fax Number:
888-681-9011
Provider Enumeration Date:
06/05/2018

Additional Information

Authorized Official

Authorized Official Last Name:
FISHERBACK
Authorized Official First Name:
DIEM
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
800-260-6145

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com