1629015250 NPI number — ALBERT GALLATIN HOME CARE AND HOSPICE SERVICES, LLC

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 1629015250 NPI number — ALBERT GALLATIN HOME CARE AND HOSPICE SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALBERT GALLATIN HOME CARE AND HOSPICE SERVICES, LLC
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:
6
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:
1629015250
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/14/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3854 AMERICAN WAY
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
BATON ROUGE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70816-4013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-292-2031
Provider Business Mailing Address Fax Number:
225-295-9678

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
649 CHERRY TREE LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNIONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15401-8947
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-439-4440
Provider Business Practice Location Address Fax Number:
724-438-2072
Provider Enumeration Date:
06/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MIGLICCO
Authorized Official First Name:
TRAVIS
Authorized Official Middle Name:
Authorized Official Title or Position:
SVP TAX
Authorized Official Telephone Number:
225-299-3803

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  154499 , 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)

  • Identifier: 108176 . This is a "UPMC HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 606348200 . This is a "FEDERAL BLACK LUNG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1014856420010 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1014856420011 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 162461 . This is a "THREE RIVERS HEALTH PLANS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 212057 . This is a "UPMC HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1014856420006 , issued by the state of ( PW ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1019517 . This is a "GATEWAY HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1014856420007 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1014856420013 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1014856420009 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1014856420015 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1028 . This is a "BC FEDERAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 162463 . This is a "THREE RIVERS HEALTH PLANS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 254540 . This is a "HEALTH AMERICA PA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 757 . This is a "PA HIGHMARK BCBS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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