1700841137 NPI number — WINCHESTER ANESTHESIOLOGISTS INC

Table of content: (NPI 1700841137)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700841137 NPI number — WINCHESTER ANESTHESIOLOGISTS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WINCHESTER ANESTHESIOLOGISTS 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:
1700841137
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/26/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3297
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINCHESTER
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22604-2495
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-662-8336
Provider Business Mailing Address Fax Number:
540-662-8593

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
878 FOX DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINCHESTER
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22603-8613
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-662-8336
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ORANTESMARTINEZ
Authorized Official First Name:
RHONDA
Authorized Official Middle Name:
K
Authorized Official Title or Position:
DELAGATED OFFICIAL
Authorized Official Telephone Number:
540-662-8336

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2134174 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0396881000 . This is a "IBC PROVIDER ID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1017991 . This is a "BRICKSTREET WORKERS COMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 221163 . This is a "SOUTHERN HEALTH" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 148860700 . This is a "US DEPT OF LABOR" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 0008206000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 051519 . This is a "ANTHEM BS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 105462 . This is a "OPTIMAHEALTH GROUP NUMBER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 148860700 . This is a "FEDERAL BLACK LUNG" identifier . This identifiers is of the category "OTHER".




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