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General NPI Number Information
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NPI Number | 1881054302
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Entity Type | Organization
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Legal Business Name | EASTERN MENNONITE UNIVERSITY
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Dates
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Enumeration Date | 02/25/2016
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Last Update Date | 02/25/2016
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Provider Practice Location Address
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Address Line | 1200 PARK RD
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City | HARRISONBURG
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State | VA
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Zip | 22802-2404
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Country | US
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Telephone | 540-432-4308
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Fax | 540-432-4099
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Provider Business Mailing Address
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Address Line | 1200 PARK RD
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City | HARRISONBURG
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State | VA
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Zip | 22802-2404
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Country | US
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Telephone | 540-432-4308
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Fax | 540-432-4099
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Authorized Official
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Title or Position | DIRECTOR OF HEALTH SERVICES
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Name | MRS. IRENE H. KNISS
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Credential | RN BSN
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Telephone | 540-432-4302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 207Q00000X
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License Number State | VA
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