Provider Demographics
NPI:1053683367
Name:GLEN HUDSON GENERAL CONTRACTING INC.
Entity Type:Organization
Organization Name:GLEN HUDSON GENERAL CONTRACTING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:GLEN
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-672-6540
Mailing Address - Street 1:14114 LITTLE ZION RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:VA
Mailing Address - Zip Code:22960-3012
Mailing Address - Country:US
Mailing Address - Phone:540-672-6540
Mailing Address - Fax:866-841-7194
Practice Address - Street 1:14114 LITTLE ZION RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:VA
Practice Address - Zip Code:22960-3012
Practice Address - Country:US
Practice Address - Phone:540-672-6540
Practice Address - Fax:866-841-7194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2705044747A332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment