Provider Demographics
NPI:1487890919
Name:DOE RUN BUILDERS INCORPORATION
Entity type:Organization
Organization Name:DOE RUN BUILDERS INCORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WADE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-251-8034
Mailing Address - Street 1:711 DOE RUN RD
Mailing Address - Street 2:
Mailing Address - City:ARARAT
Mailing Address - State:VA
Mailing Address - Zip Code:24053-3173
Mailing Address - Country:US
Mailing Address - Phone:276-251-8034
Mailing Address - Fax:276-251-8034
Practice Address - Street 1:711 DOE RUN RD
Practice Address - Street 2:
Practice Address - City:ARARAT
Practice Address - State:VA
Practice Address - Zip Code:24053-3173
Practice Address - Country:US
Practice Address - Phone:276-251-8034
Practice Address - Fax:276-251-8034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2701022454A171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty