1003945676 NPI number — PATIENT FIRST RICHMOND PHYSICIAN'S GROUP PC

Table of content: AUTUMN KAPUA EAKIN PERRY PHARMD (NPI 1649534173)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003945676 NPI number — PATIENT FIRST RICHMOND PHYSICIAN'S GROUP PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PATIENT FIRST RICHMOND PHYSICIAN'S GROUP PC
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:
Provider Other Organization Name Type Code:
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:
1003945676
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/28/2017
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:
SUITE 100
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:
804-968-5700
Provider Business Mailing Address Fax Number:
804-217-7991

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5000 COX RD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
GLEN ALLEN
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23060-9263
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-968-5700
Provider Business Practice Location Address Fax Number:
804-217-7991
Provider Enumeration Date:
03/02/2007

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: "N" .
  • Taxonomy code: 261QU0200X , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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