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General NPI Number Information
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NPI Number | 1417065806
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Entity Type | Organization
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Legal Business Name | JAMES MADISON UNIVERSITY SHENANDOAH VALLEY CHILD DEVELOPMENT CLINIC
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Dates
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Enumeration Date | 08/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 601 UNIVERSITY BLVD
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City | HARRISONBURG
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State | VA
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Zip | 22807-0001
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Country | US
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Telephone | 540-568-6687
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Fax | 540-568-3875
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Provider Business Mailing Address
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Address Line | JMU MSC 9011
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City | HARRISONBURG
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State | VA
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Zip | 22807-0001
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Country | US
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Telephone | 540-568-6687
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Fax | 540-568-3875
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Authorized Official
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Title or Position | BILLING SPECIALIST
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Name | KRIS CHRISTOPHEL
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Credential |
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Telephone | 540-568-2621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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