Provider Demographics
NPI:1063749778
Name:C.R.SCRUBS
Entity type:Organization
Organization Name:C.R.SCRUBS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-694-1141
Mailing Address - Street 1:4850 GEORGE WASHINGTON MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:HAYES
Mailing Address - State:VA
Mailing Address - Zip Code:23072-2828
Mailing Address - Country:US
Mailing Address - Phone:804-694-1141
Mailing Address - Fax:
Practice Address - Street 1:4850 GEORGE WASHINGTON MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:HAYES
Practice Address - State:VA
Practice Address - Zip Code:23072-2828
Practice Address - Country:US
Practice Address - Phone:804-694-1141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-17
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA18837332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies