1972559318 NPI number — CRESTVIEW NORTH, INC

Table of content: (NPI 1972559318)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972559318 NPI number — CRESTVIEW NORTH, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CRESTVIEW NORTH, 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:
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:
1972559318
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/21/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 E STATE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KENNETT SQUARE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19348-3109
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-925-4436
Provider Business Mailing Address Fax Number:
610-925-4351

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
262 TOLLGATE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANGHORNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19047-1377
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-968-4650
Provider Business Practice Location Address Fax Number:
215-860-5336
Provider Enumeration Date:
05/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DROPESKEY
Authorized Official First Name:
JANE
Authorized Official Middle Name:
Authorized Official Title or Position:
CORPORATE MANAGER
Authorized Official Telephone Number:
610-925-4231

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  030802 , 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: 001228 . This is a "HORIZION - SUB" identifier . This identifiers is of the category "OTHER".
  • Identifier: 21013 . This is a "HEALTH PARTNERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 317122 . This is a "US FAMILY HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 93311 . This is a "AETNA-HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 395459 . This is a "HORIZION - SNF" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0005917000 . This is a "IBC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0005917000 . This is a "AMERIHEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 112 . This is a "ELDER HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: IY0225 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1066445 . This is a "KEYSTONE MERCY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0008332840001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 255068 . This is a "HEALTH AMERICA" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com