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General NPI Number Information
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NPI Number | 1609108794
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Entity Type | Organization
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Legal Business Name | R S YOUNG CONSTRUCTION, LLC
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Dates
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Enumeration Date | 02/01/2010
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Last Update Date | 02/01/2010
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Provider Practice Location Address
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Address Line | 7994 ELLERSON STATION DR
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City | MECHANICSVILLE
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State | VA
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Zip | 23111-1800
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Country | US
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Telephone | 804-306-1451
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Fax |
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Provider Business Mailing Address
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Address Line | 7994 ELLERSON STATION DR
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City | MECHANICSVILLE
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State | VA
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Zip | 23111-1800
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Country | US
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Telephone | 804-306-1451
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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. ROBERT S YOUNG
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Credential |
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Telephone | 804-306-1451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | 171W00000X
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License Number State | VA
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