1508830993 NPI number — VIRGINIA HIGHLANDS ANESTHESIA, PC

Table of content: MRS. MARGARET LORRAINE KOLER MFTI (NPI 1124215611)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508830993 NPI number — VIRGINIA HIGHLANDS ANESTHESIA, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VIRGINIA HIGHLANDS ANESTHESIA, PC
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:
1508830993
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1476
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ABINGDON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24212-1476
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
276-628-9794
Provider Business Mailing Address Fax Number:
276-628-1260

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
351 COURT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ABINGDON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24210-2921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
276-676-7127
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SIMCOX
Authorized Official First Name:
MARK
Authorized Official Middle Name:
W.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
276-676-7127

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , 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)





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