Provider Demographics
NPI:1669715454
Name:TANNER/ZAREMBA CONST CO., INC
Entity type:Organization
Organization Name:TANNER/ZAREMBA CONST CO., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:TANNER
Authorized Official - Suffix:
Authorized Official - Credentials:BUILDING CONTRACTOR
Authorized Official - Phone:540-423-1055
Mailing Address - Street 1:1207 SPOTSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LOCUST GROVE
Mailing Address - State:VA
Mailing Address - Zip Code:22508-2139
Mailing Address - Country:US
Mailing Address - Phone:540-423-1055
Mailing Address - Fax:
Practice Address - Street 1:1207 SPOTSWOOD DR
Practice Address - Street 2:
Practice Address - City:LOCUST GROVE
Practice Address - State:VA
Practice Address - Zip Code:22508-2139
Practice Address - Country:US
Practice Address - Phone:540-423-1055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-01
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2701022436320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities