1639251796 NPI number — OCEANBRIDGE COMMUNICATIONS INC

Table of content: (NPI 1639251796)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639251796 NPI number — OCEANBRIDGE COMMUNICATIONS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OCEANBRIDGE COMMUNICATIONS 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:
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:
1639251796
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
35 SUMMIT AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHADDS FORD
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19317-9037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-358-4666
Provider Business Mailing Address Fax Number:
610-358-4666

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
35 SUMMIT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHADDS FORD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19317-9037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-358-4666
Provider Business Practice Location Address Fax Number:
610-358-4666
Provider Enumeration Date:
10/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LIEBNER
Authorized Official First Name:
CATHERINE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
610-358-4666

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  AT000461L , 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: 1154155 . This is a "KEYSTONE MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 00294019 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0461605000 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01650378-01 . This is a "AETNA US HEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com