Provider Demographics
NPI:1043527989
Name:VIRGINIA HEALTH SOLUTIONS, INC.
Entity Type:Organization
Organization Name:VIRGINIA HEALTH SOLUTIONS, INC.
Other - Org Name:VIRGINIA HEALTH SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CANARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-223-8000
Mailing Address - Street 1:815 MIDDLE GROUND BLVD
Mailing Address - Street 2:INSIDE ONELIFE FITNESS
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4209
Mailing Address - Country:US
Mailing Address - Phone:757-223-8000
Mailing Address - Fax:757-223-8966
Practice Address - Street 1:815 MIDDLE GROUND BLVD
Practice Address - Street 2:INSIDE ONELIFE FITNESS
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4209
Practice Address - Country:US
Practice Address - Phone:757-223-8000
Practice Address - Fax:757-223-8966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555575111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA242498OtherANTHEM
VA0104555575OtherSTATE LICENSE
VA1699878611OtherDR TRAVIS WILSON - INDIVIDUAL NPI
VA9832201OtherAETNA