1457304750 NPI number — GADSDEN HOME CARE SERVICES LLC

Table of content: (NPI 1457304750)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457304750 NPI number — GADSDEN HOME CARE SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GADSDEN HOME CARE SERVICES LLC
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:
1457304750
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
82 INDUSTRIAL BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATTALLA
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35954-3361
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-538-7460
Provider Business Mailing Address Fax Number:
256-538-0138

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
82 INDUSTRIAL BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATTALLA
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35954-3361
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-538-7460
Provider Business Practice Location Address Fax Number:
256-538-7460
Provider Enumeration Date:
05/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HOLTSFORD
Authorized Official First Name:
LAURIE
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR, BUSINESS OFFICE SERVICES
Authorized Official Telephone Number:
615-465-7466

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  11652 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: PIC1504E , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com