1558404806 NPI number — AMERICAN HOME CARE SYSTEM INC

Table of content: (NPI 1558404806)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558404806 NPI number — AMERICAN HOME CARE SYSTEM INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICAN HOME CARE SYSTEM 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:
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:
1558404806
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/24/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
98029 HEKAHA STREET
Provider Second Line Business Mailing Address:
UNIT #41
Provider Business Mailing Address City Name:
AIEA
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-486-4954
Provider Business Mailing Address Fax Number:
808-486-4783

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
98029 HEKAHA STREET
Provider Second Line Business Practice Location Address:
UNIT #41
Provider Business Practice Location Address City Name:
AIEA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-486-4954
Provider Business Practice Location Address Fax Number:
808-486-4783
Provider Enumeration Date:
02/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GAAD
Authorized Official First Name:
NICANOR
Authorized Official Middle Name:
SALVADOR
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
808-486-4954

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 95307 . This is a "HMSA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 07153201 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".




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