1568432474 NPI number — HEALTH FACILITIES INC

Table of content: (NPI 1568432474)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568432474 NPI number — HEALTH FACILITIES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH FACILITIES 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:
HOMEPLUS
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:
1568432474
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/03/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
909 GORMAN AVE STE 6
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELKINS
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26241-3100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-637-3628
Provider Business Mailing Address Fax Number:
304-637-5606

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
909 GORMAN AVE STE 6
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELKINS
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26241-3100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-637-3628
Provider Business Practice Location Address Fax Number:
304-637-5606
Provider Enumeration Date:
01/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KOCH
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
304-637-3196

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 550375433002 . This is a "PEIA" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 0001394001 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 550375433-01 . This is a "WORKERS COMPENSATION" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: V001548 . This is a "CHAMPUS" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 071072900 . This is a "BLACK LUNG" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 000324485 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 1405710 . This is a "UMWA" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".




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