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General NPI Number Information
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NPI Number | 1356682223
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL REFINISHING/REMODELING
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Dates
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Enumeration Date | 03/02/2013
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Last Update Date | 03/02/2013
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Provider Practice Location Address
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Address Line | 203 GREENVILLE SCHOOL RD
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City | GREENVILLE
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State | VA
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Zip | 24440-1728
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Country | US
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Telephone | 540-946-9176
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Fax |
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Provider Business Mailing Address
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Address Line | 203 GREENVILLE SCHOOL RD
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City | GREENVILLE
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State | VA
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Zip | 24440-1728
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Country | US
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Telephone | 540-946-9176
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MR. DONALD BAHRS
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Credential |
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Telephone | 540-946-9176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 2705110566
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License Number State | VA
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