1093748741 NPI number — CHS, INC

Table of content: (NPI 1093748741)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093748741 NPI number — CHS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHS, 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:
CARILION CLINIC PHARMACY-NEW RIVER VALLEY
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:
1093748741
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2001 CRYSTAL SPRING AVE SW
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:
24014-2462
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-676-7053
Provider Business Mailing Address Fax Number:
540-639-0151

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2900 TYLER RD
Provider Second Line Business Practice Location Address:
SUITE 1890
Provider Business Practice Location Address City Name:
CHRISTIANSBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24073-6374
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-639-1647
Provider Business Practice Location Address Fax Number:
540-639-0151
Provider Enumeration Date:
07/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WILSON
Authorized Official First Name:
ADRIAN
Authorized Official Middle Name:
SHAWN REID
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
540-266-6191

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  0201002250 , 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: 008514909 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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