1811442619 NPI number — MARYVIEW HOSPITAL

Table of content: (NPI 1811442619)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811442619 NPI number — MARYVIEW HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARYVIEW 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:
BON SECOURS HARBOUR VIEW MEDICAL PLAZA
Provider Other Organization Name Type Code:
3
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:
1811442619
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3636 HIGH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTSMOUTH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23707-3236
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-398-2200
Provider Business Mailing Address Fax Number:
757-398-2359

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7185 HARBOUR TOWNE PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUFFOLK
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23435-3656
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-398-2447
Provider Business Practice Location Address Fax Number:
757-393-4522
Provider Enumeration Date:
08/22/2016

Additional Information

Authorized Official

Authorized Official Last Name:
ROCHESTER
Authorized Official First Name:
CHARMAINE
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT, FINANCE
Authorized Official Telephone Number:
757-673-5988

Provider Taxonomy Codes

  • Taxonomy code: 261QI0500X , with the licence number:  H1830 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QX0200X , with the licence number: H1830 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QX0203X , with the licence number: H1830 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2024 www.npivalidator.com