1780913392 NPI number — EDWARDS HEALTH CARE SERVICES, INC.

Table of content: (NPI 1780913392)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780913392 NPI number — EDWARDS HEALTH CARE SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EDWARDS HEALTH CARE 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:
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:
1780913392
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/19/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 309
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUDSON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44236-0309
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-342-9555
Provider Business Mailing Address Fax Number:
330-342-9559

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
147 NC HIGHWAY 24
Provider Second Line Business Practice Location Address:
201
Provider Business Practice Location Address City Name:
MOREHEAD CITY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28557-8982
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-247-3300
Provider Business Practice Location Address Fax Number:
252-247-3390
Provider Enumeration Date:
12/10/2009

Additional Information

Authorized Official

Authorized Official Last Name:
EDWARDS
Authorized Official First Name:
DEE
Authorized Official Middle Name:
E
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
330-342-9555

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 7705188 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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