1215067350 NPI number — COMMUNITY HOME CARE

Table of content: DR. LOVE PANDEY VIMAL D.O (NPI 1255782603)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215067350 NPI number — COMMUNITY HOME CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY HOME CARE
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:
CERTIFIED HOME HEALTH AIDES OF SOMERSET COUNTY
Provider Other Organization Name Type Code:
4
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:
1215067350
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
110 W END AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOMERVILLE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08876-1824
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-725-9355
Provider Business Mailing Address Fax Number:
908-253-9672

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 W END AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOMERVILLE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08876-1824
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-725-9355
Provider Business Practice Location Address Fax Number:
908-253-9672
Provider Enumeration Date:
03/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BROPHY
Authorized Official First Name:
ALYCE
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PRESIDENT,CEO
Authorized Official Telephone Number:
908-725-9355

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HPO113200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 8825564 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com