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General NPI Number Information
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NPI Number | 1881745925
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Entity Type | Organization
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Legal Business Name | FRONTIER HEALTH
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 430 INDUSTRIAL DR
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City | PENNINGTON GAP
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State | VA
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Zip | 24277-1610
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Country | US
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Telephone | 276-546-4357
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Fax | 276-546-4640
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Provider Business Mailing Address
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Address Line | PO BOX 9054
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City | GRAY
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State | TN
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Zip | 37615-9054
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Country | US
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Telephone | 423-467-3600
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Fax | 423-467-3644
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MR. E DOUGLAS VARNEY
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Credential |
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Telephone | 423-467-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 315-02-011
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License Number State | VA
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