1760580757 NPI number — VCU HEALTH TAPPAHANNOCK HOSPITAL

Table of content: (NPI 1760580757)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760580757 NPI number — VCU HEALTH TAPPAHANNOCK HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VCU HEALTH TAPPAHANNOCK HOSPITAL
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:
1760580757
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/22/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 783692
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19178-3692
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-221-1067
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
618 HOSPITAL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAPPAHANNOCK
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22560
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-443-3311
Provider Business Practice Location Address Fax Number:
804-443-6150
Provider Enumeration Date:
09/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HARLAN
Authorized Official First Name:
ELIZABETH
Authorized Official Middle Name:
Authorized Official Title or Position:
REVENUE CYCLE DIRECTOR
Authorized Official Telephone Number:
804-221-1067

Provider Taxonomy Codes

  • Taxonomy code: 282NR1301X , with the licence number:  H1889 , 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)

  • Identifier: 4900847 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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