1124104161 NPI number — MS. LINDA THURBY-HAY C.N.S.

Table of content: MS. LINDA THURBY-HAY C.N.S. (NPI 1124104161)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124104161 NPI number — MS. LINDA THURBY-HAY C.N.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THURBY-HAY
Provider First Name:
LINDA
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
C.N.S.
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:
1124104161
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/05/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 91734
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23291-1734
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-358-6100
Provider Business Mailing Address Fax Number:
804-342-7619

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1250 E MARSHALL STREET
Provider Second Line Business Practice Location Address:
INTERNAL MEDICINE
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23298-0510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-828-7672
Provider Business Practice Location Address Fax Number:
804-828-3673
Provider Enumeration Date:
10/31/2006

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: 364S00000X , with the licence number:  0015000433 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 005511089 541581185 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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