Basic Information
| Provider Information | |||||||||
| NPI: | 1104857820 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | VI GOVERNMENT HOSPITAL AND HEALTH FACILITIES CORP | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | CHARLOTTE KIMELMAN CANCER INSTITUTE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 12240 | ||||||||
| Address2: | |||||||||
| City: | ST THOMAS | ||||||||
| State: | VI | ||||||||
| PostalCode: | 008015240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3407768311 | ||||||||
| FaxNumber: | 3407146318 | ||||||||
| Practice Location | |||||||||
| Address1: | 9048 SUGAR EST | ||||||||
| Address2: | |||||||||
| City: | ST THOMAS | ||||||||
| State: | VI | ||||||||
| PostalCode: | 008023634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3407768311 | ||||||||
| FaxNumber: | 3407146318 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2006 | ||||||||
| LastUpdateDate: | 01/19/2011 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | TAYLOR | ||||||||
| AuthorizedOfficialFirstName: | ALICE | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF EXECUTIVE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 3407768311 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | SCHNEIDER REGIONAL MEDICAL CENTER | ||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QX0203X | VI | Y | Ambulatory Health Care Facilities | Clinic/Center | Oncology, Radiation |
No ID Information.