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Upper Mattaponi Indian Tribe

NPI Registration Record

Provider / OrganizationNPIDate Certified
UPPER MATTAPONI INDIAN TRIBE12054140002021-07-12

The organization Upper Mattaponi Indian Tribe is registered with the National Plan and Provider Enumeration System (NPPES) and has the assigned NPI of 1205414000. Registration indicates Upper Mattaponi Indian Tribe is a provider of services with a specialization in Laboratories, Clinical Medical Laboratory (Clinical Medical Laboratory, ) (Diagnostics/Imaging/Laboratory/Mammography, ) (Clinical Medical Laboratory, Laboratories)

Entity TypeOrganization
Provider OrganizationUPPER MATTAPONI INDIAN TRIBE
Other Provider OrganizationAYLETT FAMILY WELLNESS
Practice Office Address7864 RICHMOND TAPPAHANNOCK HWY
AYLETT, VA US
Practice Office Telephone8016318362
Mailing Address7864 RICHMOND TAPPAHANNOCK HWY
AYLETT, VA 230093056 US
Authorized OfficialLANCE JOHNSON, DIRECTOR
8016318362
HPT Codes
CodePractice
License No
State
291U00000X PRIMARY
Laboratories
Clinical Medical Laboratory
Clinical Medical Laboratory

Diagnostics/Imaging/Laboratory/Mammography

Clinical Medical Laboratory
Laboratories
OPI Codes
Governmental Registrations [CAGE/NCAGE/DUNS]
NCAGE Code
84SZ3
CAGE Code
84SZ3

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