Provider Demographics
NPI:1477737955
Name:NOTTOWAY DEPARTMENT OF SOCIAL SERVICES
Entity Type:Organization
Organization Name:NOTTOWAY DEPARTMENT OF SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:REITMIEIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-645-8494
Mailing Address - Street 1:PO BOX 26
Mailing Address - Street 2:
Mailing Address - City:NOTTOWAY
Mailing Address - State:VA
Mailing Address - Zip Code:23955-0026
Mailing Address - Country:US
Mailing Address - Phone:434-645-8494
Mailing Address - Fax:434-645-7643
Practice Address - Street 1:288 WEST COURTHOUSE ROAD
Practice Address - Street 2:
Practice Address - City:NOTTOWAY
Practice Address - State:VA
Practice Address - Zip Code:23955
Practice Address - Country:US
Practice Address - Phone:434-645-8494
Practice Address - Fax:434-645-7643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0087412042Medicaid