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General NPI Number Information
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NPI Number | 1669695052
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Entity Type | Organization
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Legal Business Name | CARILION MEDICAL CENTER
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 101 ELM AVE SE
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City | ROANOKE
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State | VA
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Zip | 24013-2222
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Country | US
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Telephone | 540-981-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 213 S JEFFERSON ST STE 1006
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City | ROANOKE
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State | VA
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Zip | 24011-1713
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Country | US
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Telephone | 540-224-5715
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Fax | 540-224-5684
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONAL SUPPORT
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Name | NICOLE GRISETTI
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Credential |
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Telephone | 540-224-5352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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