Provider Demographics
NPI:1477586238
Name:GREENBRIER INTEGRATED MEDICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:GREENBRIER INTEGRATED MEDICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:540-962-8822
Mailing Address - Street 1:PO BOX 916
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24426-0916
Mailing Address - Country:US
Mailing Address - Phone:540-962-8822
Mailing Address - Fax:540-962-8824
Practice Address - Street 1:411 W RIVERSIDE ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:VA
Practice Address - Zip Code:24426-0916
Practice Address - Country:US
Practice Address - Phone:540-962-8822
Practice Address - Fax:540-962-8824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherFEIN
VAC08319Medicare PIN