APOSTOLIC CHRISTIAN HOME OF ROANOKE ILLINOIS INC. NPI 1770030074

NPI Information

NPI: 1770030074
Provider Name: APOSTOLIC CHRISTIAN HOME OF ROANOKE ILLINOIS INC.
Classification: Durable Medical Equipment & Medical Supplies - 332BX2000X
Entity Type: Organization

Specialization: Oxygen Equipment & Supplies

Address:
1102 W RANDOLPH ST
ROANOKE, IL
ZIP 61561
Phone: (309) 923-2071
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APOSTOLIC CHRISTIAN HOME OF ROANOKE ILLINOIS INC. is an oxygen equipment and supplies durable medical equipment medical supplies in Roanoke, IL. APOSTOLIC CHRISTIAN HOME OF ROANOKE ILLINOIS INC. NPI is 1770030074. The provider is registered as an organization entity type.

The provider's business location address is:

1102 W RANDOLPH ST
ROANOKE, IL
ZIP 61561-528
Phone: (309) 923-2071
Fax: (309) 923-7919

The provider's authorized official is Richard D Isaia .
The authorized official title is Administrator and has the following contact phone number (309) 923-2071.

The enumeration date for this NPI number is 9/2/2016 and was last updated on 1/24/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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	332BX2000X	Durable Medical Equipment & Medical Supplies	Oxygen Equipment & Supplies	0021493	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0021493	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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