Organization Name: | NOTTOWAY INNOVATIVE MEDICAL SOLUTIONS |
NPI Number: | 1003126756 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RUDEL CHINNERY (PRESIDENT) |
Mailing Address: | 1279 W 10th St Ste 116 Blackstone |
State: | VA US |
Postal Code: | 238243071 |
Phone Number: | 7039300046 |
Fax Number: | |
NPI Enumeration Date: | 10/15/2010 |
NPI Last Update Date: | 10/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Multi-Specialty |
Taxonomy Definition: |