1821700162 NPI number — SPAY NEUTER INCENTIVE PROGRAM OF WEST VIRGINIA

Table of content: (NPI 1821700162)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821700162 NPI number — SPAY NEUTER INCENTIVE PROGRAM OF WEST VIRGINIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPAY NEUTER INCENTIVE PROGRAM OF WEST VIRGINIA
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:
1821700162
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/19/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
975 GREENTREE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINTER PARK
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32789-2787
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-386-5937
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1470 EARL L CORE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORGANTOWN
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26505-5884
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-386-5937
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/19/2022

Additional Information

Authorized Official

Authorized Official Last Name:
CURTIS
Authorized Official First Name:
CARRIE
Authorized Official Middle Name:
Authorized Official Title or Position:
BOARD PRESIDENT
Authorized Official Telephone Number:
904-386-5937

Provider Taxonomy Codes

  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: EP0553669 . This is a "VET SERVICES" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com