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General NPI Number Information
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NPI Number | 1811668676
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Entity Type | Organization
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Legal Business Name | CARILION HEALTHCARE CORPORATION
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Dates
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Enumeration Date | 09/22/2021
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 1111 S JEFFERSON ST
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City | ROANOKE
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State | VA
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Zip | 24016-4724
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Country | US
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Telephone | 540-855-6800
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Fax | 540-857-9710
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Provider Business Mailing Address
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Address Line | 213 S JEFFERSON ST STE 625
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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 | 540-224-5894
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Fax |
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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 | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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