Provider Demographics
NPI:1659998920
Name:SCHIFFERT HEALTH CENTER
Entity Type:Organization
Organization Name:SCHIFFERT HEALTH CENTER
Other - Org Name:SCHIFFERT HEALTH CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KANITTA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAROENSIRI
Authorized Official - Suffix:
Authorized Official - Credentials:DO, MBA
Authorized Official - Phone:540-231-5313
Mailing Address - Street 1:895 WASHINGTON STREET SW VIRGINIA TECH MCCOMAS HALL
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24061-0140
Mailing Address - Country:US
Mailing Address - Phone:540-231-3256
Mailing Address - Fax:
Practice Address - Street 1:895 WASHINGTON STREET SW VIRGINIA TECH MCCOMAS HALL
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24061-0140
Practice Address - Country:US
Practice Address - Phone:540-231-3256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCHIFFERT HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-02
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy