Provider Demographics
NPI: | 1902248941 |
---|---|
Name: | VIRGINIA PHYSICIANS,INC |
Entity type: | Organization |
Organization Name: | VIRGINIA PHYSICIANS,INC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | OFFICE MANAGERE |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | DENISE |
Authorized Official - Middle Name: | LORRAINE |
Authorized Official - Last Name: | CIN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 804-228-3627 |
Mailing Address - Street 1: | 228 WADSWORTH DR |
Mailing Address - Street 2: | |
Mailing Address - City: | RICHMOND |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 23236-4803 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 804-228-3627 |
Mailing Address - Fax: | 804-560-1312 |
Practice Address - Street 1: | 11301 POLO PL |
Practice Address - Street 2: | SUITE B |
Practice Address - City: | MIDLOTHIAN |
Practice Address - State: | VA |
Practice Address - Zip Code: | 23113-4803 |
Practice Address - Country: | US |
Practice Address - Phone: | 804-379-9255 |
Practice Address - Fax: | 804-379-6293 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | VIRGINIA PHYSICIANS, INC |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2013-07-18 |
Last Update Date: | 2013-07-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Single Specialty |