1295076396 NPI number — COMMUNITY HEALTH PROFESSIONALS, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295076396 NPI number — COMMUNITY HEALTH PROFESSIONALS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY HEALTH PROFESSIONALS, 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:
HOSPICE THE CARING WAY OF BRYAN
Provider Other Organization Name Type Code:
5
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:
1295076396
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/14/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
127 BLAKESLEE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRYAN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43506-1692
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-633-7590
Provider Business Mailing Address Fax Number:
419-633-7480

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
127 BLAKESLEE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRYAN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43506-1692
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-633-7590
Provider Business Practice Location Address Fax Number:
419-633-7480
Provider Enumeration Date:
03/14/2013

Additional Information

Authorized Official

Authorized Official Last Name:
TOW
Authorized Official First Name:
BRENT
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO PRESIDENT
Authorized Official Telephone Number:
419-238-9223

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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