1679812275 NPI number — HUNTER HOLMES MCGUIRE VETERAN ADMINISTRATION MEDICAL CENTER

Table of content: DR. NATALEE NICOLE TREVINO DDS (NPI 1396006540)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679812275 NPI number — HUNTER HOLMES MCGUIRE VETERAN ADMINISTRATION MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HUNTER HOLMES MCGUIRE VETERAN ADMINISTRATION MEDICAL CENTER
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:
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Provider Other Name Suffix Text:
Provider Other Credential Text:
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NPI Number Information

NPI Number:
1679812275
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/04/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1201 BROAD ROCK BLVD
Provider Second Line Business Mailing Address:
SOCIAL WORK SERVICES-#122
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23249-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-675-5000
Provider Business Mailing Address Fax Number:
804-675-5293

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1201 BROAD ROCK BLVD
Provider Second Line Business Practice Location Address:
SOCIAL WORK SERVICES-#122
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23249-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-675-5000
Provider Business Practice Location Address Fax Number:
804-675-5293
Provider Enumeration Date:
02/04/2013

Additional Information

Authorized Official

Authorized Official Last Name:
CHRISTIAN
Authorized Official First Name:
CHARLENE
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
SOCIAL WORKER
Authorized Official Telephone Number:
804-675-5000

Provider Taxonomy Codes

  • Taxonomy code: 286500000X , with the licence number:  0903001710 , 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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