1467456970 NPI number — CRAWFORD COUNTY COMMISSIONERS

Table of content: KRISTIN NICOLE KAGER PA (NPI 1114104593)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467456970 NPI number — CRAWFORD COUNTY COMMISSIONERS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CRAWFORD COUNTY COMMISSIONERS
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:
CRAWFORD COUNTY CARE CENTER
Provider Other Organization Name Type Code:
3
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:
1467456970
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20881 STATE HWY 198
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAEGERTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16433-6159
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-763-2445
Provider Business Mailing Address Fax Number:
814-763-2108

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20881 STATE HWY 198
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAEGERTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16433-6159
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-763-2445
Provider Business Practice Location Address Fax Number:
814-763-2108
Provider Enumeration Date:
06/13/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BABCOCK
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
M
Authorized Official Title or Position:
FINANCE DIRECTOR
Authorized Official Telephone Number:
814-763-2445

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  193002 , 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: 0007476220002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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