1578607438 NPI number — HAND REHABILITATION OF HAMPTON ROADS, INC

Table of content: (NPI 1578607438)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578607438 NPI number — HAND REHABILITATION OF HAMPTON ROADS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAND REHABILITATION OF HAMPTON ROADS, 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:
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:
1578607438
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:
229 W BUTE ST
Provider Second Line Business Mailing Address:
#810
Provider Business Mailing Address City Name:
NORFOLK
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23510-1405
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-623-0814
Provider Business Mailing Address Fax Number:
757-625-5893

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4016 RAINTREE RD
Provider Second Line Business Practice Location Address:
#300A
Provider Business Practice Location Address City Name:
CHESAPEAKE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23321-3700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-405-0047
Provider Business Practice Location Address Fax Number:
757-405-1488
Provider Enumeration Date:
02/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LAFFERTY
Authorized Official First Name:
GIA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
757-623-0814

Provider Taxonomy Codes

  • Taxonomy code: 225XH1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com