1083800221 NPI number — SITTER-BARFOOT VETERANS CARE CENTER

Table of content: (NPI 1083800221)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083800221 NPI number — SITTER-BARFOOT VETERANS CARE CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SITTER-BARFOOT VETERANS CARE CENTER
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:
SITTER AND BARFOOT VETERANS CARE CENTER
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:
1083800221
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/01/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1601 BROAD ROCK BLVD
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:
23224-4923
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-371-8000
Provider Business Mailing Address Fax Number:
804-230-2097

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 BROAD ROCK BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23224-4923
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-371-8000
Provider Business Practice Location Address Fax Number:
804-230-2097
Provider Enumeration Date:
09/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
NESSAR
Authorized Official First Name:
GHULAM
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF PHARMACY
Authorized Official Telephone Number:
804-371-8000

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336L0003X , with the licence number: 0201004198 , 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: 2106323 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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