1891958971 NPI number — THREE RIVERS HEALTH DISTRICT

Table of content: (NPI 1891958971)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891958971 NPI number — THREE RIVERS HEALTH DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THREE RIVERS HEALTH DISTRICT
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:
1891958971
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/08/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P O BOX 415
Provider Second Line Business Mailing Address:
2780 PULLER HWY
Provider Business Mailing Address City Name:
SALUDA
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23149-0415
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-758-2381
Provider Business Mailing Address Fax Number:
804-758-4828

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2780 PULLER HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALUDA
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23149-0415
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-758-2381
Provider Business Practice Location Address Fax Number:
804-758-4828
Provider Enumeration Date:
07/08/2008

Additional Information

Authorized Official

Authorized Official Last Name:
BELVIN
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
D
Authorized Official Title or Position:
FISCAL TECH
Authorized Official Telephone Number:
804-758-2381

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X , with the licence number:  0401004548 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 266549 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 8450587 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 106882 . This is a "DORAL" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 266546 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 8454510 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 106879 . This is a "DORAL" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 106883 . This is a "DORAL" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4975642 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4976029 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 106880 . This is a "DORAL" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 266552 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4975669 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 266544 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4975456 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8451222 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 106881 . This is a "DORAL" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 266547 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 266553 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 266554 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4975529 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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