1699956987 NPI number — LUTHERAN FAMILY SERVICES OF VIRGINIA, INC.

Table of content: BOBBI CHRISTINE THACKER ARNP (NPI 1033424924)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699956987 NPI number — LUTHERAN FAMILY SERVICES OF VIRGINIA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LUTHERAN FAMILY SERVICES OF VIRGINIA, INC.
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:
1699956987
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/15/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2609 MCVITTY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROANOKE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24018-3513
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-774-7100
Provider Business Mailing Address Fax Number:
540-774-1084

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26 W BOSCAWEN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINCHESTER
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22601-4739
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-450-2782
Provider Business Practice Location Address Fax Number:
540-450-2783
Provider Enumeration Date:
11/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KING
Authorized Official First Name:
FREIDA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
ACCOUNTING MANAGER
Authorized Official Telephone Number:
540-774-7100

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  272-05-001 , 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)





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