1285671248 NPI number — COLUMBIA/HCA JOHN RANDOLPH, INC.

Table of content: (NPI 1285671248)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285671248 NPI number — COLUMBIA/HCA JOHN RANDOLPH, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COLUMBIA/HCA JOHN RANDOLPH, 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:
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:
1285671248
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/14/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
411 W RANDOLPH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOPEWELL
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23860-2938
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-541-1600
Provider Business Mailing Address Fax Number:
804-452-3466

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
411 W RANDOLPH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOPEWELL
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23860-2938
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-541-1600
Provider Business Practice Location Address Fax Number:
804-452-3466
Provider Enumeration Date:
05/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MAREK
Authorized Official First Name:
PATRICK
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
804-452-3650

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 451271500 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 030704400 . This is a "BLACK LUNG" identifier . This identifiers is of the category "OTHER".
  • Identifier: 909044400 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100649 . This is a "WELLPOINT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10993A , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 229116 . This is a "ALLIANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 163944300 . This is a "DEPT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000784682X , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 174473 . This is a "QUALCHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 004900201 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4900020 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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