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General NPI Number Information
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NPI Number | 1538403993
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Entity Type | Organization
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Legal Business Name | PRIORITY HEALTH CARE
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Dates
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Enumeration Date | 11/23/2012
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Last Update Date | 11/23/2012
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Provider Practice Location Address
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Address Line | 2048 MIDWAY AVE
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City | CHESAPEAKE
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State | VA
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Zip | 23324-2849
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Country | US
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Telephone | 808-372-9768
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Fax |
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Provider Business Mailing Address
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Address Line | 2048 MIDWAY AVE
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City | CHESAPEAKE
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State | VA
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Zip | 23324-2849
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Country | US
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Telephone | 808-372-9768
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. CHRISTOPHER WILSON
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Credential |
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Telephone | 808-372-9768
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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