1639277981 NPI number — DR. ANGIE SPEICHER D.C.

Table of content: DR. ANGIE SPEICHER D.C. (NPI 1639277981)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639277981 NPI number — DR. ANGIE SPEICHER D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPEICHER
Provider First Name:
ANGIE
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

Provider's Other Name Information

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 Information

NPI Number:
1639277981
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/13/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
212 E PITTSBURGH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15601-3328
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-834-1300
Provider Business Mailing Address Fax Number:
724-838-7200

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
212 E PITTSBURGH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-3328
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-834-1300
Provider Business Practice Location Address Fax Number:
724-838-7200
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  008705 , 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: 1505406 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0019744000002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1505406 . This is a "HIGHMARK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 163537 . This is a "UNISON" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 661760 . This is a "ACN GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 7662529 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1974400 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1048400 . This is a "ASHN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1536149 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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