1477614964 NPI number — VIRGINIA PHYSICIANS INC

Table of content: (NPI 1477614964)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477614964 NPI number — VIRGINIA PHYSICIANS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VIRGINIA PHYSICIANS INC
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:
HEMATOLOGY ONCOLOGY DIVISION
Provider Other Organization Name Type Code:
5
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:
1477614964
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/03/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 70069
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23255-0069
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-346-1780
Provider Business Mailing Address Fax Number:
804-346-1781

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4900 COX RD
Provider Second Line Business Practice Location Address:
SUITE 150
Provider Business Practice Location Address City Name:
GLEN ALLEN
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23060-6507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-346-1780
Provider Business Practice Location Address Fax Number:
804-346-1781
Provider Enumeration Date:
12/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LARUE
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
804-926-8571

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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