Provider Demographics
NPI:1245472950
Name:CRAFTMASTERS OF VIRGINIA, INC.
Entity type:Organization
Organization Name:CRAFTMASTERS OF VIRGINIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-556-4510
Mailing Address - Street 1:2486 LOG CABIN RD
Mailing Address - Street 2:
Mailing Address - City:MAIDENS
Mailing Address - State:VA
Mailing Address - Zip Code:23102-2224
Mailing Address - Country:US
Mailing Address - Phone:804-556-4510
Mailing Address - Fax:804-556-3290
Practice Address - Street 1:2486 LOG CABIN RD
Practice Address - Street 2:
Practice Address - City:MAIDENS
Practice Address - State:VA
Practice Address - Zip Code:23102-2224
Practice Address - Country:US
Practice Address - Phone:804-556-4510
Practice Address - Fax:804-556-3290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2705035510332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment