Provider Demographics
NPI:1215987276
Name:CITY OF NEWPORT NEWS
Entity type:Organization
Organization Name:CITY OF NEWPORT NEWS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:757-975-5047
Mailing Address - Street 1:PO BOX 717012
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19171-7012
Mailing Address - Country:US
Mailing Address - Phone:888-221-8469
Mailing Address - Fax:757-975-5068
Practice Address - Street 1:3303 JEFFERSON AVENUE
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23607
Practice Address - Country:US
Practice Address - Phone:757-975-5030
Practice Address - Fax:757-975-5068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA346341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA590000203OtherRR CARE
VA67318OtherOPTIMA
VA009001891Medicaid
VA229856OtherANTHEM
VA009001891Medicaid