1316243207 NPI number — SHAHINA RAHIM MERCHANT MHS, PA -C

Table of content: SHAHINA RAHIM MERCHANT MHS, PA -C (NPI 1316243207)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316243207 NPI number — SHAHINA RAHIM MERCHANT MHS, PA -C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MERCHANT
Provider First Name:
SHAHINA
Provider Middle Name:
RAHIM
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MHS, PA -C
Provider Gender Code:
F

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:
1316243207
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/05/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3421 CONCORD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YORK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17402-9001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-721-4740
Provider Business Mailing Address Fax Number:
717-738-6872

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
169 MARTIN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EPHRATA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17522-1724
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-721-4740
Provider Business Practice Location Address Fax Number:
717-738-6872
Provider Enumeration Date:
02/10/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  MA054829 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AM0700X , with the licence number: MA054829 , 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: P01372052 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2686821 . This is a "HIGHMARK BLUE SHIELD - FREEDOM BLUE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1604869 . This is a "GATEWAY MEDICARE ASSURED" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1604869 . This is a "GATEWAY HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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