Provider Demographics
NPI:1922182286
Name:NCH RESIDENCY CLINIC
Entity Type:Organization
Organization Name:NCH RESIDENCY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER, CPSC
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:STURGILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-679-8890
Mailing Address - Street 1:96 15TH ST NW
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NORTON
Mailing Address - State:VA
Mailing Address - Zip Code:24273-1620
Mailing Address - Country:US
Mailing Address - Phone:276-679-8890
Mailing Address - Fax:276-679-9740
Practice Address - Street 1:716 SPRING AVE NE
Practice Address - Street 2:WISE PROFESSIONAL OFFICE BLDG
Practice Address - City:WISE
Practice Address - State:VA
Practice Address - Zip Code:24293-5702
Practice Address - Country:US
Practice Address - Phone:276-328-3394
Practice Address - Fax:276-328-3396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care