1851387138 NPI number — WESTMINSTER CANTERBURY OF WINCHESTER INC

Table of content: (NPI 1851387138)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851387138 NPI number — WESTMINSTER CANTERBURY OF WINCHESTER INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WESTMINSTER CANTERBURY OF WINCHESTER 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:
SHENANDOAH VALLEY WESTMINSTER CANTERBURY
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:
1851387138
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/18/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 WESTMINSTER CANTERBURY DR
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:
22603-4216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-665-0156
Provider Business Mailing Address Fax Number:
540-665-9781

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 WESTMINSTER CANTERBURY 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:
22603-4216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-665-0156
Provider Business Practice Location Address Fax Number:
540-665-9781
Provider Enumeration Date:
09/22/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WERNECKE
Authorized Official First Name:
DUANE
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
540-665-0156

Provider Taxonomy Codes

  • Taxonomy code: 310400000X , with the licence number:  NH2688 , 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: 4951654 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".