1932167921 NPI number — ALLIANCE VISITING NURSES

Table of content: (NPI 1932167921)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932167921 NPI number — ALLIANCE VISITING NURSES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLIANCE VISITING NURSES
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:
1932167921
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/04/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18201 CONNEAUT LAKE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEADVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16335-3757
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-333-7000
Provider Business Mailing Address Fax Number:
814-333-7001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18360 CONNEAUT LAKE RD STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEADVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16335-3735
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-333-7000
Provider Business Practice Location Address Fax Number:
814-333-7001
Provider Enumeration Date:
05/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DUNN
Authorized Official First Name:
TIMOTHY
Authorized Official Middle Name:
KLINE
Authorized Official Title or Position:
EXCECUTIVE DIRECTOR
Authorized Official Telephone Number:
814-333-7000

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  765505 , 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: 1064 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1511871 . This is a "GATWAY INSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 39D0910166 . This is a "CLIA WAIVER CERTIFICATE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0015567230008 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 675 . This is a "MPI PROVIDER ID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 765505 . This is a "PA STATE H/H LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0700144 00 . This is a "DEPT OF LABOR - BLACK LUN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com