Healthcare Provider Details

I. General information

NPI: 1407054869
Provider Name (Legal Business Name): NEW KENT COUNTY BOARD OF SUPERVISORS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 08/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12025 COURTHOUSE CIRCLE SUITE 400
NEW KENT VA
23124
US

IV. Provider business mailing address

P O BOX 210
NEW KENT VA
23124-0210
US

V. Phone/Fax

Practice location:
  • Phone: 804-966-8574
  • Fax: 804-966-2903
Mailing address:
  • Phone: 804-966-8574
  • Fax: 804-966-2903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number693
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number693
License Number StateVA

VIII. Authorized Official

Name: MR. RODNEY A. HATHAWAY
Title or Position: ACTING COUNTY ADMINISTRATOR
Credential:
Phone: 804-966-9629