Provider Demographics
NPI:1225144298
Name:RAPPAHANNOCK AREA HEALTH DISTRICT
Entity Type:Organization
Organization Name:RAPPAHANNOCK AREA HEALTH DISTRICT
Other - Org Name:MOSS DENTAL
Other - Org Type:Other Name
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAKOWSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-899-4797
Mailing Address - Street 1:608 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-5719
Mailing Address - Country:US
Mailing Address - Phone:540-899-4797
Mailing Address - Fax:540-899-4599
Practice Address - Street 1:435 HUNTER ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3434
Practice Address - Country:US
Practice Address - Phone:540-741-1061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA104961OtherDORAL
VA145079OtherANTHEM-HANSEN
VA144856OtherANTHEM-MILLER