Provider Demographics
NPI:1053560219
Name:WIGGINS & COMPANY'S
Entity type:Organization
Organization Name:WIGGINS & COMPANY'S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED SURGICAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:DWIGHT
Authorized Official - Middle Name:V
Authorized Official - Last Name:DEADMON
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:804-328-2289
Mailing Address - Street 1:1002 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-5943
Mailing Address - Country:US
Mailing Address - Phone:804-909-9429
Mailing Address - Fax:804-328-2289
Practice Address - Street 1:1002 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-5943
Practice Address - Country:US
Practice Address - Phone:804-909-2942
Practice Address - Fax:804-328-2289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-12
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA3196282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital