1487659769 NPI number — PATHWAYS HOME HEALTH AND HOSPICE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487659769 NPI number — PATHWAYS HOME HEALTH AND HOSPICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PATHWAYS HOME HEALTH AND HOSPICE
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:
1487659769
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/11/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
585 N MARY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUNNYVALE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94085-2905
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-730-1500
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
585 N MARY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUNNYVALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94085-2905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-730-1500
Provider Business Practice Location Address Fax Number:
408-730-8726
Provider Enumeration Date:
06/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HAWKINS
Authorized Official First Name:
JACK
Authorized Official Middle Name:
Authorized Official Title or Position:
VP FINANCE & CFO
Authorized Official Telephone Number:
513-576-8478

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  070000462 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: CA181928 . This is a "MEDICARE PART B" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: HPC01580F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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