Provider Demographics
NPI:1356307847
Name:EMPOWER2000, INC
Entity type:Organization
Organization Name:EMPOWER2000, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:
Authorized Official - Last Name:PECK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-277-8151
Mailing Address - Street 1:PO BOX 413
Mailing Address - Street 2:
Mailing Address - City:PEARISBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24134-0413
Mailing Address - Country:US
Mailing Address - Phone:800-277-8151
Mailing Address - Fax:
Practice Address - Street 1:1 TAYLOR AVE
Practice Address - Street 2:
Practice Address - City:PEARISBURG
Practice Address - State:VA
Practice Address - Zip Code:24134-1932
Practice Address - Country:US
Practice Address - Phone:800-277-8151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC08950Medicare ID - Type UnspecifiedMEDICARE