1861469439 NPI number — ESCHMAN PHYSICAL THERAPY, LLC

Table of content: (NPI 1861469439)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861469439 NPI number — ESCHMAN PHYSICAL THERAPY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ESCHMAN PHYSICAL THERAPY, 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:
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:
1861469439
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/03/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2581 NORTH RD NE
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
WARREN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44483-3052
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-372-5800
Provider Business Mailing Address Fax Number:
330-372-5841

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2581 NORTH RD NE
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
WARREN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44483-3052
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-372-5800
Provider Business Practice Location Address Fax Number:
330-372-5841
Provider Enumeration Date:
03/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ESCHMAN
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
M
Authorized Official Title or Position:
OWNER/PHYSICAL THERAPIST
Authorized Official Telephone Number:
330-372-5800

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X , with the licence number:  PT004472 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QP2000X , with the licence number: PT013103L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 001749093 . This is a "VENDOR NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2838522 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001584013 . This is a "PERFORMING PROVIDER NO." identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000354746 . This is a "PRACTITIONER PIN ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: DF4463 . This is a "MEDICARE RAIL ROAD GROUP" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000354745 . This is a "GROUP PIN ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: P00366333 . This is a "MEDICARE RAIL ROAD PIN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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