Healthcare Provider Details

I. General information

NPI: 1639610967
Provider Name (Legal Business Name): CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6425 RICHMOND ROAD
WILLIAMSBURG VA
23188-7202
US

IV. Provider business mailing address

601 CHILDRENS LN
NORFOLK VA
23507-1910
US

V. Phone/Fax

Practice location:
  • Phone: 757-345-3242
  • Fax:
Mailing address:
  • Phone: 757-668-9647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number49D2124303
License Number StateVA

VIII. Authorized Official

Name: KATHRYN J ABSHIRE
Title or Position: SENIOR VP CFO
Credential:
Phone: 757-668-8565