1770741894 NPI number — FAMILIES UNITED NETWORK INC

Table of content: (NPI 1770741894)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770741894 NPI number — FAMILIES UNITED NETWORK INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILIES UNITED NETWORK 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:
1770741894
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 264
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MUNCY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17756-0264
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-546-6777
Provider Business Mailing Address Fax Number:
570-546-8898

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
276 ASHLER MANOR DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PENNSDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17756
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-546-6777
Provider Business Practice Location Address Fax Number:
570-546-8898
Provider Enumeration Date:
05/27/2008

Additional Information

Authorized Official

Authorized Official Last Name:
KRINER
Authorized Official First Name:
LORI
Authorized Official Middle Name:
Authorized Official Title or Position:
ACCOUNTING MANAGER
Authorized Official Telephone Number:
570-546-6777

Provider Taxonomy Codes

  • Taxonomy code: 253J00000X , with the licence number:  312470 , 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: 0016498310006 . This is a "PROMISE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 00164986310001 . This is a "PROMISE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0016498310005 . This is a "PROMISE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0016498310003 . This is a "PROMISE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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