1063484947 NPI number — DR. SCOTT C COLE M.D.

Table of content: DR. SCOTT C COLE M.D. (NPI 1063484947)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063484947 NPI number — DR. SCOTT C COLE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLE
Provider First Name:
SCOTT
Provider Middle Name:
C
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1063484947
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/15/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1430
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARRISONBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22803-1430
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-564-7084
Provider Business Mailing Address Fax Number:
540-564-6847

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2010 HEALTH CAMPUS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRISONBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22801-8679
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-689-1110
Provider Business Practice Location Address Fax Number:
540-689-1119
Provider Enumeration Date:
02/03/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  0101052556 , 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: 183899 . This is a "ANTHEM- STRASBURG" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 292395 . This is a "ANTHEM- WOODSTOCK" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 010203261 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 020620218 . This is a "TAX ID#" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 006736190 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".