NPIMap

Organization Active NPI

Olivet Medical Ministry, Inc

  • Clinic Pharmacy
  • Yorktown, VA
National Provider Identifier
1427582352
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
0201003931 Issued in VA
Legal business name
OLIVET MEDICAL MINISTRY, INC
Practice address
1620 Old Williamsburg Rd
Yorktown, VA 23690-3910
Phone
(757) 886-0608
Fax
(757) 968-5022
NPI assigned
Apr 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carol Sale, RN, MSN
Title
Executive Director
Phone
(757) 886-0608

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 0201003931 VA Primary

Addresses

Primary practice location

1620 Old Williamsburg Rd
Yorktown, VA 23690-3910

Mailing address

1620 Old Williamsburg Rd
Yorktown, VA 23690-3910
Phone (757) 886-0608

Other names 1

  • LACKEY CLINIC Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492473600000",
    "number": "1427582352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 OLD WILLIAMSBURG RD",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236903910",
            "telephone_number": "757-886-0608",
            "fax_number": "757-968-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 OLD WILLIAMSBURG RD",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236903910",
            "telephone_number": "757-886-0608",
            "fax_number": "757-968-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVET MEDICAL MINISTRY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-18",
        "last_updated": "2017-04-18",
        "status": "A",
        "authorized_official_last_name": "SALE",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "757-886-0608",
        "authorized_official_credential": "RN, MSN"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "VA",
            "license": "0201003931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LACKEY CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yorktown, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.