1659385938 NPI number — CITY OF CHESAPEAKE

Table of content: (NPI 1659385938)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659385938 NPI number — CITY OF CHESAPEAKE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF CHESAPEAKE
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:
1659385938
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/04/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 16436
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHESAPEAKE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23328-6436
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-382-6709
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
304 ALBEMARLE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHESAPEAKE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23322-5502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-382-6297
Provider Business Practice Location Address Fax Number:
757-382-8288
Provider Enumeration Date:
07/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CALVERT
Authorized Official First Name:
LORRA
Authorized Official Middle Name:
Authorized Official Title or Position:
ACCOUNT PAYABLE MANAGER
Authorized Official Telephone Number:
757-382-6709

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  00449 , 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)

  • Identifier: 009002685 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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