1477705176 NPI number — REAVES-DIGGS, PARHAM & ASSOCIATES, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477705176 NPI number — REAVES-DIGGS, PARHAM & ASSOCIATES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REAVES-DIGGS, PARHAM & ASSOCIATES, LLC
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:
1477705176
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2513
Provider Second Line Business Mailing Address:
LYNCHBURG
Provider Business Mailing Address City Name:
VIRGINIA BCH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23450-2513
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-237-5005
Provider Business Mailing Address Fax Number:
434-237-5535

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
147 MILL RIDGE RD STE 203
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LYNCHBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24502-4341
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-237-5005
Provider Business Practice Location Address Fax Number:
434-237-5535
Provider Enumeration Date:
10/14/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
REAVES
Authorized Official First Name:
ELIZABETH
Authorized Official Middle Name:
TRACCINNIEA
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
434-237-5005

Provider Taxonomy Codes

  • Taxonomy code: 322D00000X , with the licence number:  SS-04-47 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 322D00000X , with the licence number: SS-381/4271-08 , 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)