1356853592 NPI number — WHOLE WOMAN'S HEALTH ALLIANCE

Table of content: (NPI 1356853592)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356853592 NPI number — WHOLE WOMAN'S HEALTH ALLIANCE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WHOLE WOMAN'S HEALTH ALLIANCE
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:
1356853592
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1001 E MARKET ST STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTESVILLE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22902-5381
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-202-8818
Provider Business Mailing Address Fax Number:
888-724-3239

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2321 COMMONWEALTH DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLOTTESVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22901-1637
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-973-4888
Provider Business Practice Location Address Fax Number:
888-724-3239
Provider Enumeration Date:
10/27/2017

Additional Information

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
VIRGINIA
Authorized Official Middle Name:
E
Authorized Official Title or Position:
CREDENTIALING COORDINATOR
Authorized Official Telephone Number:
888-737-9615

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1356853592 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com