1962955328 NPI number — PATHWAYS, INC

Table of content: (NPI 1962955328)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962955328 NPI number — PATHWAYS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PATHWAYS, 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:
1962955328
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/13/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 129
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOLLYWOOD
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20636-0129
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-373-3065
Provider Business Mailing Address Fax Number:
301-373-6143

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2670 CRAIN HWY
Provider Second Line Business Practice Location Address:
SUITE 407
Provider Business Practice Location Address City Name:
WALDORF
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20601-2806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-374-9137
Provider Business Practice Location Address Fax Number:
301-374-9136
Provider Enumeration Date:
08/02/2016

Additional Information

Authorized Official

Authorized Official Last Name:
MCGLOIN
Authorized Official First Name:
GERARD
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
301-373-3065

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  MH-2000 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com