1467429688 NPI number — A & H STORES, INC.

Table of content: (NPI 1467429688)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467429688 NPI number — A & H STORES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A & H STORES, 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:
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:
1467429688
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/18/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25022 104TH AVE SE
Provider Second Line Business Mailing Address:
SUITE E
Provider Business Mailing Address City Name:
KENT
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98030-2822
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-520-0333
Provider Business Mailing Address Fax Number:
253-520-0444

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25022 104TH AVE SE
Provider Second Line Business Practice Location Address:
SUITE E
Provider Business Practice Location Address City Name:
KENT
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98030-2822
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-852-1123
Provider Business Practice Location Address Fax Number:
253-852-3167
Provider Enumeration Date:
03/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HENDRICKSON
Authorized Official First Name:
STACEY
Authorized Official Middle Name:
J
Authorized Official Title or Position:
GENERAL COUNSEL
Authorized Official Telephone Number:
253-520-0333

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  CF60260557 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 6028419 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4931362 . This is a "NABP" identifier . This identifiers is of the category "OTHER".




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