Provider Demographics
NPI:1831711902
Name:CHARLOTTESVILLE HYPERBARICS CORP
Entity type:Organization
Organization Name:CHARLOTTESVILLE HYPERBARICS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:O'NEILL
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:434-293-1143
Mailing Address - Street 1:925-A E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-5573
Mailing Address - Country:US
Mailing Address - Phone:434-293-1143
Mailing Address - Fax:
Practice Address - Street 1:925-A E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-5573
Practice Address - Country:US
Practice Address - Phone:434-293-1143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center