Provider Demographics
NPI:1417190141
Name:ANDERSON-DOUGLAS INC
Entity Type:Organization
Organization Name:ANDERSON-DOUGLAS INC
Other - Org Name:ANDERSON-DOUGLAS CONSTRUCTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-572-4323
Mailing Address - Street 1:2532 BROAD BAY RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-1639
Mailing Address - Country:US
Mailing Address - Phone:757-572-4323
Mailing Address - Fax:757-481-0023
Practice Address - Street 1:2532 BROAD BAY RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-1639
Practice Address - Country:US
Practice Address - Phone:757-572-4323
Practice Address - Fax:757-481-0023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-10
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2705118727A171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty