Provider Demographics
NPI:1518380674
Name:DEPARTMENT OF HEALTH, EMS STX
Entity Type:Organization
Organization Name:DEPARTMENT OF HEALTH, EMS STX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LORNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:340-773-1311
Mailing Address - Street 1:3500 ESTATE RICHMOND
Mailing Address - Street 2:DEPARTMENT OF HEALTH CHARLES HARWOOD COMPLEX
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00820-4370
Mailing Address - Country:US
Mailing Address - Phone:340-773-1311
Mailing Address - Fax:
Practice Address - Street 1:3500 ESTATE RICHMOND
Practice Address - Street 2:DEPARTMENT OF HEALTH CHARLES HARWOOD COMPLEX
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-4323
Practice Address - Country:US
Practice Address - Phone:340-773-1311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
VICN076AMedicare PIN