1184607442 NPI number — VIRGINIA COMMONWEALTH UNIVERSITY

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 1184607442 NPI number — VIRGINIA COMMONWEALTH UNIVERSITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VIRGINIA COMMONWEALTH UNIVERSITY
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:
1184607442
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 980263
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:
23298-0263
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-828-9685
Provider Business Mailing Address Fax Number:
804-828-0283

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1112 E CLAY ST
Provider Second Line Business Practice Location Address:
4TH FLOOR, ROOM 114
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23298-5057
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-828-6322
Provider Business Practice Location Address Fax Number:
804-828-0283
Provider Enumeration Date:
11/21/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SCHWARTZ
Authorized Official First Name:
LAWRENCE
Authorized Official Middle Name:
B.
Authorized Official Title or Position:
PROFESSOR AND CHAIR
Authorized Official Telephone Number:
804-828-9685

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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