Provider Demographics
NPI:1174578736
Name:CITY OF HAMPTON VIRGINIA
Entity type:Organization
Organization Name:CITY OF HAMPTON VIRGINIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BATTALION CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:BETTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:REEVES-NOBLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-727-1318
Mailing Address - Street 1:PO BOX 3192
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23663-0192
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1300 THOMAS ST
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-3067
Practice Address - Country:US
Practice Address - Phone:757-727-1202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF HAMPTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-23
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA417341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010077770Medicaid
VA190000950Medicare ID - Type Unspecified