Organization
OXBOW CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TYANNA MARIE CHAFFIN (SECRETARY BOOKKEEPER)
(276) 762-0700
Entity
Organization
Contact information
Practice address
16620 E RIVERSIDE DRIVE, ST PAUL, VA 24283-1017
(276) 762-0700
(276) 762-0620
Mailing address
PO BOX 1017, 16620 E RIVERSIDE DRIVE, ST PAUL, VA 24283-1017
(276) 762-0700
(276) 762-0620
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
WLO06158
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008730202
—
VA
Enumeration date
09/14/2006
Last updated
08/22/2020
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