Provider Demographics
NPI:1588878474
Name:CENTRAL VIRGINIA HEALTH SERVICES INC
Entity type:Organization
Organization Name:CENTRAL VIRGINIA HEALTH SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-581-4073
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:NEW CANTON
Mailing Address - State:VA
Mailing Address - Zip Code:23123-0220
Mailing Address - Country:US
Mailing Address - Phone:434-581-4073
Mailing Address - Fax:
Practice Address - Street 1:321C POPLAR DR
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-9306
Practice Address - Country:US
Practice Address - Phone:804-733-5591
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC02846Medicare PIN
VA491874Medicare Oscar/Certification