Provider Demographics
NPI:1902934680
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 1:4260 CROSSINGS BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:PRINCE GEORGE
Practice Address - State:VA
Practice Address - Zip Code:23875-1400
Practice Address - Country:US
Practice Address - Phone:434-542-5560
Practice Address - Fax:434-542-5745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
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
VA010110670Medicaid
VA491861Medicare Oscar/Certification
VA010110670Medicaid