1427355908 NPI number — FRANCISCAN BRETHREN OF ST PHILIP

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 1427355908 NPI number — FRANCISCAN BRETHREN OF ST PHILIP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRANCISCAN BRETHREN OF ST PHILIP
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:
1427355908
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/18/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1356
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLIAMSBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23187-1356
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-208-0224
Provider Business Mailing Address Fax Number:
757-208-0348

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6422 CENTERVILLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILLIAMSBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23188-1739
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-208-0224
Provider Business Practice Location Address Fax Number:
757-208-0349
Provider Enumeration Date:
02/18/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WALUBUKA
Authorized Official First Name:
MARGARETWALUBUKA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
757-256-6937

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X , with the licence number:  750-02-006 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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