1801167424 NPI number — CHI NATIONAL HOME CARE, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801167424 NPI number — CHI NATIONAL HOME CARE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHI NATIONAL HOME CARE, LLC
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:
CHI ST. VINCENT HEALTH AT HOME
Provider Other Organization Name Type Code:
3
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:
1801167424
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6281 TRI RIDGE BLVD STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45140-8345
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-576-0262
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
211 HELICOPTER LN STE 205
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORRILTON
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72110-4514
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-977-2396
Provider Business Practice Location Address Fax Number:
501-977-2267
Provider Enumeration Date:
01/13/2012

Additional Information

Authorized Official

Authorized Official Last Name:
HAWKINS
Authorized Official First Name:
JACK
Authorized Official Middle Name:
Authorized Official Title or Position:
V.P. FINANCE & CFO
Authorized Official Telephone Number:
513-576-8478

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 195147514 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".




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