Provider Demographics
NPI:1386694024
Name:CENTRAL VIRGINIA PEDIATRICS INC
Entity type:Organization
Organization Name:CENTRAL VIRGINIA PEDIATRICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARITY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-233-8534
Mailing Address - Street 1:101 COWARDIN AVENUE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224
Mailing Address - Country:US
Mailing Address - Phone:804-233-8534
Mailing Address - Fax:804-864-5216
Practice Address - Street 1:101 COWARDIN AVENUE
Practice Address - Street 2:SUITE 207
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224
Practice Address - Country:US
Practice Address - Phone:804-233-8534
Practice Address - Fax:804-864-5216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F81406Medicare UPIN
C09211Medicare ID - Type Unspecified