Provider Demographics
NPI:1649406679
Name:COUNTRY CONTRACTORS, INC.
Entity Type:Organization
Organization Name:COUNTRY CONTRACTORS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:TUFTEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-566-8474
Mailing Address - Street 1:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:TOANO
Mailing Address - State:VA
Mailing Address - Zip Code:23168-0550
Mailing Address - Country:US
Mailing Address - Phone:757-566-8474
Mailing Address - Fax:757-566-8711
Practice Address - Street 1:7683 RICHMOND RD.
Practice Address - Street 2:
Practice Address - City:TOANO
Practice Address - State:VA
Practice Address - Zip Code:23168
Practice Address - Country:US
Practice Address - Phone:757-566-8474
Practice Address - Fax:757-566-8711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2701019832A171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty