Provider Demographics
NPI:1215947510
Name:PULMONARY MEDICINE OF VIRGINIA PLC
Entity type:Organization
Organization Name:PULMONARY MEDICINE OF VIRGINIA PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:276-783-1827
Mailing Address - Street 1:1305 RADFORD ST
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-2867
Mailing Address - Country:US
Mailing Address - Phone:540-381-2200
Mailing Address - Fax:540-381-8342
Practice Address - Street 1:1305 RADFORD ST
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-2867
Practice Address - Country:US
Practice Address - Phone:540-381-2200
Practice Address - Fax:540-381-8342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DA5658OtherRAILROAD MEDICARE GROUP
VA268379OtherANTHEM
VAC08860Medicare PIN