1518493394 NPI number — JAY HASH LLC

Table of content: (NPI 1518493394)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518493394 NPI number — JAY HASH LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAY HASH LLC
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:
HOPESOURCE
Provider Other Organization Name Type Code:
3
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:
1518493394
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 GALLIA ST
Provider Second Line Business Mailing Address:
SUITE 600
Provider Business Mailing Address City Name:
PORTSMOUTH
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45662-4035
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-353-4673
Provider Business Mailing Address Fax Number:
740-353-5800

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 GALLIA ST
Provider Second Line Business Practice Location Address:
SUITE 600
Provider Business Practice Location Address City Name:
PORTSMOUTH
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45662-4035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-353-4673
Provider Business Practice Location Address Fax Number:
740-353-5800
Provider Enumeration Date:
05/11/2017

Additional Information

Authorized Official

Authorized Official Last Name:
HASH
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
LAWLER
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
740-727-1520

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  01-7576 , 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)

  • Identifier: 0144728 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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