1790914315 NPI number — HEALTH PROFESSIONALS OF HOLMES COUNTY, INC

Table of content: (NPI 1790914315)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790914315 NPI number — HEALTH PROFESSIONALS OF HOLMES COUNTY, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH PROFESSIONALS OF HOLMES COUNTY, 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:
1790914315
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/02/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1261 WOOSTER RD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
MILLERSBURG
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44654-1568
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-674-2822
Provider Business Mailing Address Fax Number:
330-763-2063

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4606 TOWNSHIP RD 634
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MT. HOPE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-674-4711
Provider Business Practice Location Address Fax Number:
330-674-0124
Provider Enumeration Date:
07/02/2009

Additional Information

Authorized Official

Authorized Official Last Name:
MOLNAR
Authorized Official First Name:
ROB
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
330-674-1015

Provider Taxonomy Codes

  • Taxonomy code: 261QU0200X , with the licence number:  N/A , 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)





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