Provider Demographics
NPI:1942451067
Name:OLD DOMINION INVESTMENT AND DEVELOPMENT
Entity Type:Organization
Organization Name:OLD DOMINION INVESTMENT AND DEVELOPMENT
Other - Org Name:OLD DOMINION IMPROVEMENTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GOGARTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-363-9500
Mailing Address - Street 1:733 MARALON DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-2230
Mailing Address - Country:US
Mailing Address - Phone:757-363-9500
Mailing Address - Fax:757-523-0500
Practice Address - Street 1:733 MARALON DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-2230
Practice Address - Country:US
Practice Address - Phone:757-363-9500
Practice Address - Fax:757-523-0500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAA39606253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care