1487923603 NPI number — SENTINEL MANAGEMENT SERVICES INC.

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 1487923603 NPI number — SENTINEL MANAGEMENT SERVICES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SENTINEL MANAGEMENT SERVICES 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:
SENTINEL4HEALTH
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:
1487923603
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/16/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
118 W AIRPORT RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITITZ
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17543-9259
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-581-1245
Provider Business Mailing Address Fax Number:
717-581-8841

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
118 W AIRPORT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LITITZ
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17543-9259
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-581-1245
Provider Business Practice Location Address Fax Number:
717-581-8841
Provider Enumeration Date:
12/16/2011

Additional Information

Authorized Official

Authorized Official Last Name:
HETTRICK
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
MELVIN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
717-581-1245

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , 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)





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