=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700267192
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INSIGHT ENTERPRISES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/11/2015
-----------------------------------------------------
Last Update Date | 06/11/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2021A CUNNINGHAM DR STE 2
-----------------------------------------------------
City | HAMPTON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23666-3320
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-827-0275
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2021A CUNNINGHAM DR STE 2
-----------------------------------------------------
City | HAMPTON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23666-3320
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-827-0275
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | RALPH SHELMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 757-827-0275
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------