=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548066947
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VIRGIN ISLANDS HEALTHCARE FOUNDATION, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/25/2025
-----------------------------------------------------
Last Update Date | 11/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4500 SUNNY ISLE SPC 123A
-----------------------------------------------------
City | CHRISTIANSTED
-----------------------------------------------------
State | VI
-----------------------------------------------------
Zip | 00820-4493
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 340-715-7720
-----------------------------------------------------
Fax | 340-713-9002
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3004 ORANGE GROVE SUITE 2
-----------------------------------------------------
City | CHRISTIANSTED
-----------------------------------------------------
State | VI
-----------------------------------------------------
Zip | 00820
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 340-715-7720
-----------------------------------------------------
Fax | 340-713-9002
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CREDENTIALING SPECIALIST
-----------------------------------------------------
Name | ANGELA K. EAST
-----------------------------------------------------
Credential | MBA
-----------------------------------------------------
Telephone | 340-201-3157
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QR1300X
-----------------------------------------------------
Taxonomy Name | Rural Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------