1982268967 NPI number — BEST IN-HOME HEALTH SERVICES

Table of content: (NPI 1982268967)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982268967 NPI number — BEST IN-HOME HEALTH SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEST IN-HOME HEALTH SERVICES
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:
1982268967
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/25/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 600418
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT PAUL
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55106-0007
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-701-4301
Provider Business Mailing Address Fax Number:
651-330-1802

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1686 SUBURBAN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST PAUL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55106-5510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-701-4301
Provider Business Practice Location Address Fax Number:
651-330-1802
Provider Enumeration Date:
04/25/2019

Additional Information

Authorized Official

Authorized Official Last Name:
WHITLEY
Authorized Official First Name:
LATONYA
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRINCIPAL EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
612-701-4301

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1080776600053 . This is a "MN TAX FILE NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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