1750389193 NPI number — CHOICES HEALTHCARE

Table of content: AMY MICHELLE BOND FNP (NPI 1144855289)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750389193 NPI number — CHOICES HEALTHCARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHOICES HEALTHCARE
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:
1750389193
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/25/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4125
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LANCASTER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17604-4125
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-295-3900
Provider Business Mailing Address Fax Number:
717-391-9582

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
685 GOOD DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17604-4125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-295-3900
Provider Business Practice Location Address Fax Number:
717-391-9582
Provider Enumeration Date:
07/11/2005

Additional Information

Authorized Official

Authorized Official Last Name:
KNAUB
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
717-295-3900

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  07391600 , 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: 20007398 . This is a "AMERIHEALTH HEALTH PLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 20007398 . This is a "HEALTHCARE DELAWARE, INC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0003403000 . This is a "KEYSTONE HEALTH PLAN EAST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 20007398 . This is a "AMERIHEALTH ADMIN INC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 391515 . This is a "KEYSTONE HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 64297 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 20007398 . This is a "AMERIHEALTH MERCY HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1007575790004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1512954 . This is a "GATEWAY HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 20007398 . This is a "INTER-COUNTY HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0135 . This is a "HIGHMARK BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 20007398 . This is a "AMERIHEALTH INSURANCE CO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 391515 . This is a "CAPITAL BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 702780 . This is a "FEDERAL BLACK LUNG" identifier . This identifiers is of the category "OTHER".




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