1932118916 NPI number — ANCIRO PSC

Table of content: (NPI 1932118916)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932118916 NPI number — ANCIRO PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANCIRO PSC
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:
1932118916
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/25/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 997
Provider Second Line Business Mailing Address:
754 S HWY 27
Provider Business Mailing Address City Name:
SOMERSET
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42502-0997
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-677-6787
Provider Business Mailing Address Fax Number:
606-451-0035

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
754 S HIGHWAY 27
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOMERSET
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42501-3509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-677-6787
Provider Business Practice Location Address Fax Number:
606-451-0035
Provider Enumeration Date:
08/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CATHERS
Authorized Official First Name:
AMY
Authorized Official Middle Name:
RENEE
Authorized Official Title or Position:
BILLING SPECIALIST
Authorized Official Telephone Number:
606-677-6787

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: DC8516 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 65942807 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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