1730163742 NPI number — TWIN COUNTY RECOVERY SERVICES INC

Table of content: (NPI 1730163742)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730163742 NPI number — TWIN COUNTY RECOVERY SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TWIN COUNTY RECOVERY SERVICES 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:
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:
1730163742
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
350 POWER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUDSON
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12534-2447
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-751-2083
Provider Business Mailing Address Fax Number:
518-828-4712

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
350 POWER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUDSON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12534-2447
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-828-9300
Provider Business Practice Location Address Fax Number:
518-828-4712
Provider Enumeration Date:
12/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
O'BRIEN
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF ADMINISTRATOR
Authorized Official Telephone Number:
518-751-2083

Provider Taxonomy Codes

  • Taxonomy code: 324500000X , with the licence number:  070111088 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 324500000X , with the licence number: 070111087 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 111934 . This is a "WELLCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 29199 . This is a "BCBS (GREENE COUNTY)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7341399 . This is a "EMPIRE PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000400493001 . This is a "BLUE SHIELD (COLUMBIA CO)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000400493002 . This is a "BLUE SHIELD (GREENE CO)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 85006 . This is a "MVP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10028759 . This is a "CDPHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 165760000 . This is a "MAGELLAN (COL CO)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00756318 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 175952000 . This is a "MAGELLAN (GREENE COUNTY)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 25890 . This is a "BCBS (COLUMBIA COUNTY)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 321354 . This is a "VALUE OPTION" identifier . This identifiers is of the category "OTHER".




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