Provider Demographics
NPI:1902999121
Name:CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC
Entity type:Organization
Organization Name:CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP CFO
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ABSHIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-668-8565
Mailing Address - Street 1:601 CHILDRENS LN
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1910
Mailing Address - Country:US
Mailing Address - Phone:757-668-7017
Mailing Address - Fax:757-668-8929
Practice Address - Street 1:601 CHILDRENS LN
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1910
Practice Address - Country:US
Practice Address - Phone:757-668-7017
Practice Address - Fax:757-668-8929
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-02
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
No283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000620505Medicaid
VA236297OtherALLIANCE
VA4900961OtherVIRGINIA PREMIER
VA009013857Medicaid
VA236297OtherOPTIMUM CHOICE
VA004930177Medicaid
VA0096618OtherAETNA
VA000082OtherANTHEM BC BS
VA169288OtherANTHEM REFERENCE LAB
VA236297OtherMDIPA
NC001AYOtherSTATE OF NC TEACHERS & ST
VA184601OtherANTHEM OYSTER POINT
WV0175123000Medicaid
VA116838OtherANTHEM TRANSPORT
NC4903301Medicaid
VA004900961Medicaid
DE0000620505Medicaid
VA184601OtherANTHEM OYSTER POINT
VA=========OtherTRICARE (HEALTHNET)
VA=========OtherCIGNA