1881390086 NPI number — HANDS OF STANDARD LLC

Table of content: (NPI 1881390086)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881390086 NPI number — HANDS OF STANDARD LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HANDS OF STANDARD 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:
1881390086
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/31/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 253
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GEORGIANA
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36033-0253
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-376-0075
Provider Business Mailing Address Fax Number:
334-376-0158

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
241 HANKS AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GEORGIANA
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-376-0075
Provider Business Practice Location Address Fax Number:
334-376-0158
Provider Enumeration Date:
01/31/2023

Additional Information

Authorized Official

Authorized Official Last Name:
WATERS
Authorized Official First Name:
CHASTITY
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
334-437-4375

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: 1568047363 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com