1982617775 NPI number — VIRGINIA MEDICAL AND RESPIRATORY EQUIPMENT, INC.

Table of content: (NPI 1982617775)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982617775 NPI number — VIRGINIA MEDICAL AND RESPIRATORY EQUIPMENT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VIRGINIA MEDICAL AND RESPIRATORY EQUIPMENT, 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:
1982617775
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1380
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRUNDY
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24614-1380
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
276-935-8621
Provider Business Mailing Address Fax Number:
276-935-6111

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
RT 460 RIVERSIDE DRIVE
Provider Second Line Business Practice Location Address:
ROYAL CITY SECTION
Provider Business Practice Location Address City Name:
GRUNDY
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24614
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
276-935-8621
Provider Business Practice Location Address Fax Number:
276-935-6111
Provider Enumeration Date:
08/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
COMPTON
Authorized Official First Name:
RONNIE
Authorized Official Middle Name:
DENNIS
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
276-935-8621

Provider Taxonomy Codes

  • Taxonomy code: 332BP3500X , with the licence number:  0206009032 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 332BX2000X , with the licence number: 0206009032 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 1351259 . This is a "UMWA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 3810001882 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 90022666 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 322964 . This is a "ANTHEM BC/BS OF VA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: S300 . This is a "KY BC/BS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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