Provider Demographics
NPI:1700461209
Name:EXCEPTIONAL CONSTRUCTION AND PAINTING
Entity type:Organization
Organization Name:EXCEPTIONAL CONSTRUCTION AND PAINTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:WILKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-873-2785
Mailing Address - Street 1:7563 SAMBAR RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-6628
Mailing Address - Country:US
Mailing Address - Phone:804-873-2785
Mailing Address - Fax:
Practice Address - Street 1:7563 SAMBAR RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-6628
Practice Address - Country:US
Practice Address - Phone:804-873-2785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
No171W00000XOther Service ProvidersContractorGroup - Single Specialty