1477657021 NPI number — PATIENT FIRST RICHMOND MEDICAL GROUP PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477657021 NPI number — PATIENT FIRST RICHMOND MEDICAL GROUP PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PATIENT FIRST RICHMOND MEDICAL GROUP PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PATIENT FIRST - MECHANICSVILLE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477657021
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/27/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5000 COX RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLEN ALLEN
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23060-9263
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-822-4355
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7238 MECHANICSVILLE TPKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MECHANICSVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23111-3502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-559-9900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MORISON
Authorized Official First Name:
GEORGE
Authorized Official Middle Name:
H
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
804-968-5700

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CA1507 . This is a "MEDICARE RAILROAD GROUP" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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