1952307811 NPI number — AMERICAN TRANSITIONAL HOSPITALS LLC

Table of content: (NPI 1952307811)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952307811 NPI number — AMERICAN TRANSITIONAL HOSPITALS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICAN TRANSITIONAL HOSPITALS 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:
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:
1952307811
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/02/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
07/21/2005
NPI Reactivation Date:
02/22/2007

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4714 GETTYSBURG RD
Provider Second Line Business Mailing Address:
LEGAL DEPT.
Provider Business Mailing Address City Name:
MECHANICSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17055-4325
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-972-1100
Provider Business Mailing Address Fax Number:
717-975-9981

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
550 PEACHTREE ST NE
Provider Second Line Business Practice Location Address:
7TH FLOOR, WOODRUFF BUILDING
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30308-2209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-686-3284
Provider Business Practice Location Address Fax Number:
404-686-4590
Provider Enumeration Date:
06/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
TARVIN
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
E.
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
717-972-1100

Provider Taxonomy Codes

  • Taxonomy code: 282E00000X , with the licence number:  0060-558 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 51003550 . This is a "BCBS GA" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 00916881A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 50531A . This is a "LEGACY PROVIDER NUMBER" identifier . This identifiers is of the category "OTHER".




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