1932476397 NPI number — PIONEER PERSONAL CARE , INC.

Table of content: (NPI 1932476397)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932476397 NPI number — PIONEER PERSONAL CARE , INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PIONEER PERSONAL CARE , INC.
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:
1932476397
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/29/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1342
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOPEWELL
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23860-1342
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-721-7742
Provider Business Mailing Address Fax Number:
804-469-7745

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13915 BOYDTON PLANK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DINWIDDIE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23841-2451
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-469-4664
Provider Business Practice Location Address Fax Number:
804-469-7745
Provider Enumeration Date:
11/29/2011

Additional Information

Authorized Official

Authorized Official Last Name:
CROSBY
Authorized Official First Name:
BARBARA
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
804-721-7742

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0102107551 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0087005754 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0087709058 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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