1831272103 NPI number — CENTRAL VIRGINIA AUDIOLOGY SERVICES INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831272103 NPI number — CENTRAL VIRGINIA AUDIOLOGY SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRAL VIRGINIA AUDIOLOGY SERVICES 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:
1831272103
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/03/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
147 ABES WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RUSTBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24588-3128
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-947-3125
Provider Business Mailing Address Fax Number:
434-384-3976

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1330 OAK LN
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
LYNCHBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24503-2513
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-947-3125
Provider Business Practice Location Address Fax Number:
434-384-3976
Provider Enumeration Date:
10/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GILMER
Authorized Official First Name:
GRAHAM
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
434-947-3993

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , 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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