Provider Demographics
NPI:1902919673
Name:PATHOLOGY ASSOCIATES OF HARRISONBURG P.C.
Entity Type:Organization
Organization Name:PATHOLOGY ASSOCIATES OF HARRISONBURG P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GROUP PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PADGETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-689-6670
Mailing Address - Street 1:PO BOX 956
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45802-0956
Mailing Address - Country:US
Mailing Address - Phone:877-212-6920
Mailing Address - Fax:
Practice Address - Street 1:2010 HEALTH CAMPUS DR
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:VA
Practice Address - Zip Code:22801-8679
Practice Address - Country:US
Practice Address - Phone:540-689-6670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040805207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1902919673Medicaid
WV0011322000Medicaid
VA1902919673OtherNPI GROUP
VA6618600Medicaid
C01358Medicare ID - Type Unspecified
VA6650511Medicaid
220000340Medicare ID - Type Unspecified
VA220000152Medicare ID - Type Unspecified
VA6622402Medicaid
E37325Medicare UPIN
VA220000299Medicare ID - Type Unspecified