1700093416 NPI number — ADAMS BROWN COUNTIES ECONOMIC OPPT INC

Table of content: (NPI 1700093416)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700093416 NPI number — ADAMS BROWN COUNTIES ECONOMIC OPPT INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADAMS BROWN COUNTIES ECONOMIC OPPT 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:
1700093416
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/15/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
406 W. PLUM STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GEORGETOWN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45121
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-378-6041
Provider Business Mailing Address Fax Number:
937-378-2321

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9137 ST. RT. 136
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST UNION
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45693
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-544-3796
Provider Business Practice Location Address Fax Number:
937-544-8955
Provider Enumeration Date:
05/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DARBY
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
Authorized Official Title or Position:
DEPUTY DIRECTOR ABCEOI
Authorized Official Telephone Number:
937-378-6041

Provider Taxonomy Codes

  • Taxonomy code: 261QF0050X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0298495 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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