1568557395 NPI number — LAWRENCE COMMUNITY HEALTH SERVICES

Table of content: (NPI 1568557395)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568557395 NPI number — LAWRENCE COMMUNITY HEALTH SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAWRENCE COMMUNITY HEALTH SERVICES
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:
JANSEN HOSPICE & PALLIATIVE CARE
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:
1568557395
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/08/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1129 WESTCHESTER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITE PLAINS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10604-3505
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-787-6158
Provider Business Mailing Address Fax Number:
914-725-6381

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1129 WESTCHESTER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITE PLAINS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10604-3505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-787-6158
Provider Business Practice Location Address Fax Number:
914-725-6381
Provider Enumeration Date:
10/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FARRELL
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
J
Authorized Official Title or Position:
SENIOR VICE PRESIDENT FINANCE
Authorized Official Telephone Number:
212-297-4358

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 01068226 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 004049 . This is a "EMPIRE BLUE CROSS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: A378170 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com