CATHOLIC CHARITIES OF THE DIOCESE OF HARRISBURG PA INC - NPI NUMBER 1457402265

Summary

Provider Name: CATHOLIC CHARITIES OF THE DIOCESE OF HARRISBURG PA INC

NPI Number: 1457402265

Clasification: Clinic/Center (261Q00000X)

Address:
533 SOUTH MAIN
CHAMBERSBURG, PA
ZIP 17201

Phone Number: (717) 657-4804



Detailed Information

CATHOLIC CHARITIES OF THE DIOCESE OF HARRISBURG PA INC is a clinic/center in Chambersburg, PA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). The assigned NPI number for this provider is 1457402265 and is registered as an organization entity type.

The provider's business address is:

533 SOUTH MAIN
CHAMBERSBURG, PA
ZIP 17201-505
Phone: (717) 657-4804
Fax: (717) 657-8683

The provider's authorized official is Mark A Totaro .
The authorized official title is Executive Director Ceo and has the following contact phone number (717) 657-4804.

The enumeration date for this NPI number is 1/16/2007 and was last updated on 7/9/2007.

Map - Location of Practice

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 261Q00000X Clinic/Center 309960 PA Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 0018539060003 MEDICAID PA

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1457402265 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name CATHOLIC CHARITIES OF THE DIOCESE OF HARRISBURG PA INC The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider First Line Business Practice Location Address 533 SOUTH MAIN The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
6 Provider Business Practice Location Address City Name CHAMBERSBURG The city name in the location address of the provider being identified.
7 Provider Business Practice Location Address State Name PA The State code in the location of the provider being identified.
8 Provider Business Practice Location Address Postal Code 172013505 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
9 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
10 Provider Business Practice Location Address Telephone Number 7176574804 The telephone number associated with the location address of the provider being identified.
11 Provider Business Practice Location Address Fax Number 7176578683 The fax number associated with the location address of the provider being identified.
12 Provider Enumeration Date 1/16/2007 The date the provider was assigned a unique identifier (assigned an NPI).
13 Last Update Date 7/9/2007 The date that a record was last updated or changed.
14 Authorized Official Last Name TOTARO The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
15 Authorized Official First Name MARK The first name of the authorized official.
16 Authorized Official Middle Name A The middle name of the authorized official.
17 Authorized Official Title or Position EXECUTIVE DIRECTOR CEO The title or position of the authorized official.
18 Authorized Official Telephone Number 7176574804 The 10-position telephone number of the authorized official.
19 Healthcare Provider Taxonomy Code 1 261Q00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
20 Provider License Number 1 309960 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
21 Provider License Number State Code 1 PA The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
22 Healthcare Provider Primary Taxonomy Switch 1 Y
23 Other Provider Identifier 1 0018539060003 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
24 Other Provider Identifier Type Code 1 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
25 Other Provider Identifier State 1 PA
26 Authorized Official Credential Text PHD

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This page was last updated on: 4/19/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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