Provider Demographics
NPI:1255441838
Name:PLANNED PARENTHOOD SOUTHEASTERN VIRGINIA, INC
Entity type:Organization
Organization Name:PLANNED PARENTHOOD SOUTHEASTERN VIRGINIA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAULETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCELWAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-482-6161
Mailing Address - Street 1:515 NEWTOWN RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-5620
Mailing Address - Country:US
Mailing Address - Phone:757-309-4827
Mailing Address - Fax:757-309-4813
Practice Address - Street 1:515 NEWTOWN RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-5620
Practice Address - Country:US
Practice Address - Phone:757-499-7526
Practice Address - Fax:757-309-4813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7664419Medicaid