Provider Demographics
NPI:1548412737
Name:CHARLES P GILCHRIST OD INC
Entity Type:Organization
Organization Name:CHARLES P GILCHRIST OD INC
Other - Org Name:CHARLES P GILCHRIST OD INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:P
Authorized Official - Last Name:GILCHRIST
Authorized Official - Suffix:III
Authorized Official - Credentials:OD
Authorized Official - Phone:804-443-5388
Mailing Address - Street 1:402 AIRPORT RD
Mailing Address - Street 2:P.O. BOX 1137
Mailing Address - City:TAPPAHANNOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22560-5431
Mailing Address - Country:US
Mailing Address - Phone:804-443-5388
Mailing Address - Fax:804-443-5389
Practice Address - Street 1:402 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:TAPPAHANNOCK
Practice Address - State:VA
Practice Address - Zip Code:22560
Practice Address - Country:US
Practice Address - Phone:804-443-5388
Practice Address - Fax:804-443-5389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000691332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
6714280001Medicare NSC
0783720001Medicare NSC