1801921853 NPI number — CHOICE HEALTH CARE LTD

Table of content: ARYN WILSON (NPI 1487472924)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801921853 NPI number — CHOICE HEALTH CARE LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHOICE HEALTH CARE LTD
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:
1801921853
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/10/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4134 LINDEN AVE STE 202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DAYTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45432-3035
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-254-6220
Provider Business Mailing Address Fax Number:
937-254-6292

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4134 LINDEN AVE STE 202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DAYTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45432-3035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-254-6220
Provider Business Practice Location Address Fax Number:
937-254-6292
Provider Enumeration Date:
02/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
STONE
Authorized Official First Name:
MARGARET
Authorized Official Middle Name:
J
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
937-254-6220

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: 1801921853 . This is a "TRICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 312726 . This is a "AMERIGROUP" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1801921853 . This is a "DAYTON VERTERANS ADMINISTRATION" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1801921853 . This is a "PASSPORT" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 6000265 . This is a "UHC" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1801921853 . This is a "COMCARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1801921853 . This is a "CATHOLIC SOCIAL SERVICES" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1801921853 . This is a "MOLINA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000244941 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1801921853 . This is a "WALGREEN'S OPTIONCARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1801921853 . This is a "BUREAU OF WORKER'S COMPENSATION" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1801921853 . This is a "CARESOURCE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1801921853 . This is a "HUMANA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2221394 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1801921853 . This is a "CARECENTRIX" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1801921853 . This is a "MEDICAL MUTUAL OF OHIO" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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