1619024346 NPI number — ASHLAND COMMUNITY MEDICAL EQUIPMENT, INC

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619024346 NPI number — ASHLAND COMMUNITY MEDICAL EQUIPMENT, INC

Employer Identification Number (EIN):

Provider Organization Name:

ASHLAND COMMUNITY MEDICAL EQUIPMENT, 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 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:

1619024346

Entity Type Code:

Organization

Replacement NPI:

Last Update Date:

01/13/2009

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

2200 WINCHESTER AVE

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

ASHLAND

Provider Business Mailing Address State Name:

KY

Provider Business Mailing Address Postal Code:

41101-7832

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

606-324-1101

Provider Business Mailing Address Fax Number:

606-325-2629

Provider First Line Business Practice Location Address:

2200 WINCHESTER AVE

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

ASHLAND

Provider Business Practice Location Address State Name:

KY

Provider Business Practice Location Address Postal Code:

41101-7832

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

606-324-1101

Provider Business Practice Location Address Fax Number:

606-325-2629

Provider Enumeration Date:

01/04/2007

Authorized Official Last Name:

DAVIS

Authorized Official First Name:

BRUCE

Authorized Official Middle Name:

ALAN

Authorized Official Title or Position:

PRESIDENT

Authorized Official Telephone Number:

606-324-1101

• Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
• Taxonomy code: 332BC3200X , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

• Identifier: 45900362 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
• Identifier: 7066 . This is a "CHA HEALTH" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 479258 . This is a "FEDERAL BLACK LUNG" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 57649 . This is a "NORTHWOOD BC BS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 000000070189 . This is a "ANTHEM" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 1366745 . This is a "UNITED MINE WORKERS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 90020108 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
• Identifier: 1030656 . This is a "WV WORKERS COMPENSATION" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
• Identifier: 163623700 . This is a "FEDERAL WORKERS COMPENSAT" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 0146778000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
• Identifier: 0695056 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".