1770637555 NPI number — LONGWOOD UNIVERSITY

Table of content: (NPI 1770637555)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770637555 NPI number — LONGWOOD UNIVERSITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LONGWOOD UNIVERSITY
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:
LONGWOOD SPEECH, HEARING AND LEARNING SERVICES
Provider Other Organization Name Type Code:
3
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:
1770637555
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 513
Provider Second Line Business Mailing Address:
315 WEST THIRD STREET
Provider Business Mailing Address City Name:
FARMVILLE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23901-0513
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-395-2972
Provider Business Mailing Address Fax Number:
434-395-2622

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
315 W 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FARMVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23901-1201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-395-2972
Provider Business Practice Location Address Fax Number:
434-395-2622
Provider Enumeration Date:
01/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
POWER-DEFUR
Authorized Official First Name:
ELIZABETH
Authorized Official Middle Name:
ANNE
Authorized Official Title or Position:
DIRECTOR, SHLS
Authorized Official Telephone Number:
434-395-2972

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 231HA2400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 231HA2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 237600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237700000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332S00000X , with the licence number: 2101001501 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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