# PLANNED PARENTHOOD SOUTH ATLANTIC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Planned Parenthood Health Systems
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801932199
- **Authorized official:** TEARRA ALEXANDRIA RAYNOR (DIRECTOR OF REVENUE CYCLE)
- **Authorized official phone:** (919) 833-7526

## Contact information

- **Practice address:** 522 GRAND CENTRAL AVE, VIENNA, WV 26105-2169
- **Practice address phone:** (304) 295-3331
- **Practice address fax:** (304) 295-4924
- **Mailing address:** 100 S BOYLAN AVE, RALEIGH, NC 27603-1802
- **Mailing address phone:** (919) 833-7534
- **Mailing address fax:** (919) 833-0730

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QF0050X | Non-Surgical Family Planning Clinic/Center | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/30/2007
- **Last updated:** 05/28/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0008073000 | — | WV |