1427207307 NPI number — G & A ENTERPRISES PC

Table of content: (NPI 1427207307)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427207307 NPI number — G & A ENTERPRISES PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
G & A ENTERPRISES PC
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:
6
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:
1427207307
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1221
Provider Second Line Business Mailing Address:
RT 209 REGENCY PLAZA STE 9
Provider Business Mailing Address City Name:
BRODHEADSVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18322-1221
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-992-1011
Provider Business Mailing Address Fax Number:
570-402-3534

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
RT 209 REGENCY PLAZA
Provider Second Line Business Practice Location Address:
STE 9
Provider Business Practice Location Address City Name:
BRODHEADSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18322-1221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-992-1011
Provider Business Practice Location Address Fax Number:
570-402-3534
Provider Enumeration Date:
09/16/2008

Additional Information

Authorized Official

Authorized Official Last Name:
WOOD
Authorized Official First Name:
LAWRENCE
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
570-992-1011

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC009149 , 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: 001672673 . This is a "HIGHMARK BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1417921099 . This is a "INDIVIDUAL NPI" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 088648TX8 . This is a "MEDICARE INDIVIDUAL PETAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com