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DIVINE HEALTH CARE LLC NPI 1053659714


NPI Information

NPI: 1053659714
Provider Name: DIVINE HEALTH CARE, LLC

Doing Business As: DIVINE HEALTH CARE, LLC

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 49D2071498

Address:
2207 EXECUTIVE DR
STE B
HAMPTON, VA
ZIP 23666
Phone: (757) 826-1600
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DIVINE HEALTH CARE, LLC is a primary care clinic center in Hampton, VA. DIVINE HEALTH CARE, LLC NPI is 1053659714. The provider is registered as an organization entity type.
The provider Is Doing Business As Divine Health Care, Llc.

The provider's business location address is:

2207 EXECUTIVE DR
STE B
HAMPTON, VA
ZIP 23666-478
Phone: (757) 826-1600
Fax: (757) 826-0160

The provider's authorized official is Debra Foster Chinnery .
The authorized official title is Owner and has the following contact phone number (757) 826-0514.

The CLIA number assigned to this NPI record is 49D2071498 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/30/2013 and was last updated on 2/13/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary Care0017000454VIRGINIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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