1962902163 NPI number — ROBYN VENOY LSW

Table of content: ROBYN VENOY LSW (NPI 1962902163)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962902163 NPI number — ROBYN VENOY LSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VENOY
Provider First Name:
ROBYN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WAUGH
Provider Other First Name:
ROBYN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1962902163
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/05/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1049 WESTERN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHILLICOTHE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45601-1104
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-773-4366
Provider Business Mailing Address Fax Number:
740-775-7855

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
112 E MEMORIAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POMEROY
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45769-9569
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-992-2192
Provider Business Practice Location Address Fax Number:
740-992-4018
Provider Enumeration Date:
02/15/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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