1851461271 NPI number — LAWRENCE COUNTY CHIROPRACTIC

Table of content: (NPI 1851461271)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851461271 NPI number — LAWRENCE COUNTY CHIROPRACTIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAWRENCE COUNTY CHIROPRACTIC
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:
1851461271
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1700 NEW BUTLER RD
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
NEW CASTLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16101-3152
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-654-2008
Provider Business Mailing Address Fax Number:
724-652-5661

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1700 NEW BUTLER RD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16101-3152
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-654-2008
Provider Business Practice Location Address Fax Number:
724-652-5661
Provider Enumeration Date:
11/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GERAMITA
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
J
Authorized Official Title or Position:
CHIROPRACTOR
Authorized Official Telephone Number:
724-654-2008

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC-007191-1 , 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: 000000088944 . This is a "UNISON HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1506091 . This is a "GATEWAY HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 5542731 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0017363100001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: GE990499 . This is a "HIGHMARK" identifier , issued by the state of ( PW ) . This identifiers is of the category "OTHER".
  • Identifier: 2096404 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 309975 . This is a "UPMC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: GE996048 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com