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General NPI Number Information
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NPI Number | 1417190141
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Entity Type | Organization
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Legal Business Name | ANDERSON-DOUGLAS INC
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Dates
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Enumeration Date | 04/10/2009
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Last Update Date | 05/07/2009
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Provider Practice Location Address
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Address Line | 2532 BROAD BAY RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-1639
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Country | US
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Telephone | 757-572-4323
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Fax | 757-481-0023
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Provider Business Mailing Address
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Address Line | 2532 BROAD BAY RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-1639
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Country | US
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Telephone | 757-572-4323
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Fax | 757-481-0023
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICHARD DOUGLAS ANDERSON
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Credential |
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Telephone | 757-572-4323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number | 2705118727A
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License Number State | VA
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