1457785388 NPI number — VIRGINIA INTERVENTIONAL PSYCHIATRY

Table of content: (NPI 1457785388)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457785388 NPI number — VIRGINIA INTERVENTIONAL PSYCHIATRY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VIRGINIA INTERVENTIONAL PSYCHIATRY
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:
TMS NEUROHEALTH CENTERS RICHMOND
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:
1457785388
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5231 HICKORY PARK DR STE C
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:
23059-2619
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-464-8471
Provider Business Mailing Address Fax Number:
804-980-7794

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5231 HICKORY PARK DR
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
GLEN ALLEN
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23059-2619
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-980-7529
Provider Business Practice Location Address Fax Number:
804-980-7794
Provider Enumeration Date:
08/28/2013

Additional Information

Authorized Official

Authorized Official Last Name:
NEUMANN
Authorized Official First Name:
BRYCE
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
804-980-7520

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  0101235202 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 364SP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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