1104079847 NPI number — DANVILLE REGIONAL MEDICAL CENTER LLC

Table of content: ROBIN TARVER LMFT, MAC (NPI 1902324577)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104079847 NPI number — DANVILLE REGIONAL MEDICAL CENTER LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DANVILLE REGIONAL MEDICAL CENTER 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:
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:
1104079847
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
103 POWELL CT
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027-5079
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-372-8500
Provider Business Mailing Address Fax Number:
615-372-8581

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
142 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DANVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24541-2922
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-799-2100
Provider Business Practice Location Address Fax Number:
434-799-2260
Provider Enumeration Date:
10/28/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DILL
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
615-372-8500

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com