Provider Demographics
NPI:1841378023
Name:EDNA P WOOD SOMETHING SPECIAL
Entity type:Organization
Organization Name:EDNA P WOOD SOMETHING SPECIAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:P
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED FITTER
Authorized Official - Phone:434-296-5454
Mailing Address - Street 1:415 LEXINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-4711
Mailing Address - Country:US
Mailing Address - Phone:434-296-5454
Mailing Address - Fax:434-296-5454
Practice Address - Street 1:415 LEXINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-4711
Practice Address - Country:US
Practice Address - Phone:434-296-5454
Practice Address - Fax:434-296-5454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009197753OtherFIRST HEALTH SERV CORP
VA223603OtherANTHEM
VA010208114Medicaid
VA246026OtherSOUTHERN HEALTH
0333420001Medicare ID - Type Unspecified