1093850232 NPI number — PATIENT FIRST

Table of content: (NPI 1093850232)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093850232 NPI number — PATIENT FIRST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PATIENT FIRST
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:
1093850232
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/19/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5000 COX RD
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
GLEN ALLEN
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23060-9263
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
611 DENBIGH BLVD
Provider Second Line Business Practice Location Address:
PATIENT FIRST
Provider Business Practice Location Address City Name:
NEWPORT NEWS
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-283-8300
Provider Business Practice Location Address Fax Number:
757-283-8301
Provider Enumeration Date:
02/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BRIDGERS
Authorized Official First Name:
MARVIN
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF PHARMACY SERVICES
Authorized Official Telephone Number:
804-968-5700

Provider Taxonomy Codes

  • Taxonomy code: 332900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0002X , with the licence number: 0213000985 , 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: 4839417 . This is a "OTHER ID NUMBER-COMMERCIAL NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4839417 . This is a "OTHER ID NUMBER" identifier . This identifiers is of the category "OTHER".




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