Provider Demographics
NPI:1649226275
Name:CARILION SERVICES INC
Entity Type:Organization
Organization Name:CARILION SERVICES INC
Other - Org Name:CARILION FACULTY PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:LORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-224-5125
Mailing Address - Street 1:213 S JEFFERSON ST
Mailing Address - Street 2:SUITE 801
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24011-1705
Mailing Address - Country:US
Mailing Address - Phone:540-224-5125
Mailing Address - Fax:540-985-4948
Practice Address - Street 1:213 S JEFFERSON ST
Practice Address - Street 2:SUITE 801
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24011-1705
Practice Address - Country:US
Practice Address - Phone:540-224-5125
Practice Address - Fax:540-985-4948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VACI3613Medicare PIN
VAC01619Medicare Oscar/Certification
VAC07003Medicare Oscar/Certification
VACB9993Medicare PIN
VAC08149Medicare Oscar/Certification
VAC05693Medicare Oscar/Certification
VAC01619Medicare PIN
VAC06752Medicare Oscar/Certification
VAC08095Medicare Oscar/Certification
VAC07021Medicare Oscar/Certification
VAC09617Medicare Oscar/Certification
VAC05771Medicare Oscar/Certification