Provider Demographics
NPI:1386818136
Name:DRS. GOLD AND ABBOTT, LTD.
Entity Type:Organization
Organization Name:DRS. GOLD AND ABBOTT, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-989-5257
Mailing Address - Street 1:1940 BRAEBURN DR
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-7383
Mailing Address - Country:US
Mailing Address - Phone:540-989-5257
Mailing Address - Fax:
Practice Address - Street 1:1940 BRAEBURN DR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-7383
Practice Address - Country:US
Practice Address - Phone:540-989-5257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAT21402Medicare UPIN
VAT21914Medicare UPIN
VAC01191Medicare PIN