1003501396 NPI number — GOVERNMENT OF US VIRGIN ISLANDS DEPARTMENT OF FINANCE

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 1003501396 NPI number — GOVERNMENT OF US VIRGIN ISLANDS DEPARTMENT OF FINANCE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GOVERNMENT OF US VIRGIN ISLANDS DEPARTMENT OF FINANCE
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:
6
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:
1003501396
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3500 ESTATE RICHMOND
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHRISTIANSTED
Provider Business Mailing Address State Name:
VI
Provider Business Mailing Address Postal Code:
00820-4323
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
340-718-1311
Provider Business Mailing Address Fax Number:
340-712-6201

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
41B MARS HL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREDERIKSTED
Provider Business Practice Location Address State Name:
VI
Provider Business Practice Location Address Postal Code:
00840-3775
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
340-718-1311
Provider Business Practice Location Address Fax Number:
340-712-6201
Provider Enumeration Date:
04/11/2023

Additional Information

Authorized Official

Authorized Official Last Name:
MILLER
Authorized Official First Name:
LORNA
Authorized Official Middle Name:
Authorized Official Title or Position:
REVENUE COORDINATOR
Authorized Official Telephone Number:
340-718-1311

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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