1669512703 NPI number — TOWNSEND HEALTH ASSOCIATES

Table of content: (NPI 1669512703)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669512703 NPI number — TOWNSEND HEALTH ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWNSEND HEALTH ASSOCIATES
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:
1669512703
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:
5432 THUNDER HILL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21045-2270
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5432 THUNDER HILL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21045-2270
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-964-3505
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LIBEY
Authorized Official First Name:
HELEN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT, MH PRACTITIONER
Authorized Official Telephone Number:
410-964-3505

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X , with the licence number:  03866 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: KN50 W148 . This is a "BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: W1480001 . This is a "BLUECHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: KN50 . This is a "MAGELLAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 286316 . This is a "AETNA HMO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 7333087 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: PVB127670 . This is a "APS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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