1285647891 NPI number — FRIEDRICHS FAMILY EYE CENTER PC

Table of content: (NPI 1285647891)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285647891 NPI number — FRIEDRICHS FAMILY EYE CENTER PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRIEDRICHS FAMILY EYE CENTER PC
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:
1285647891
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/11/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 943
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHATHAM
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24531-0943
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-432-1500
Provider Business Mailing Address Fax Number:
434-432-1500

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
32 NORTH MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHATHAM
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24531-0943
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-432-1500
Provider Business Practice Location Address Fax Number:
434-432-1500
Provider Enumeration Date:
08/14/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FRIEDRICHS
Authorized Official First Name:
GRAY
Authorized Official Middle Name:
W.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
434-432-1500

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  0618000917 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 152W00000X , with the licence number: 0618001415 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 0618001335 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1174526008 . This is a "DR. FRIEDRICHS'S NPI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 010063272 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1114928934 . This is a "DR. BUTTERWORTH'S NPI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1568515666 . This is a "NPI DR. HARPIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010070155 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010108641 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1093800781 . This is a "CHRISTIAN NPI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".