1518055367 NPI number — ALLEGHANY HIGHLANDS COMMUNITY SERVICES

Table of content: (NPI 1518055367)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518055367 NPI number — ALLEGHANY HIGHLANDS COMMUNITY SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLEGHANY HIGHLANDS COMMUNITY SERVICES
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:
1518055367
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/25/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLIFTON FORGE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24422-1759
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-863-1600
Provider Business Mailing Address Fax Number:
540-863-1612

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
311 S MONROE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COVINGTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24426-1635
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-965-2100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/10/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FLANAGAN
Authorized Official First Name:
PATTY
Authorized Official Middle Name:
Authorized Official Title or Position:
FISCAL OFFICER
Authorized Official Telephone Number:
540-863-1600

Provider Taxonomy Codes

  • Taxonomy code: 261QR0405X , with the licence number:  12702001 , 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: 442225 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".