Provider Demographics
NPI:1154675460
Name:DAVIS & ELKINS COLLEGE
Entity Type:Organization
Organization Name:DAVIS & ELKINS COLLEGE
Other - Org Name:DAVIS & ELKINS COLLEGE ATHLETICS
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:GRETA
Authorized Official - Middle Name:
Authorized Official - Last Name:TROASTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-637-1331
Mailing Address - Street 1:100 CAMPUS DR
Mailing Address - Street 2:ATHLETICS
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-3971
Mailing Address - Country:US
Mailing Address - Phone:304-637-1397
Mailing Address - Fax:304-637-1414
Practice Address - Street 1:100 CAMPUS DR
Practice Address - Street 2:ATHLETICS
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-3971
Practice Address - Country:US
Practice Address - Phone:304-637-1397
Practice Address - Fax:304-637-1414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health