1548687452 NPI number — COLEMAN INSTITUTE RICHMOND, LLC

Table of content: (NPI 1548687452)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548687452 NPI number — COLEMAN INSTITUTE RICHMOND, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COLEMAN INSTITUTE RICHMOND, LLC
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:
6
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:
1548687452
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/23/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
204 N HAMILTON ST
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23221-2662
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-353-1230
Provider Business Mailing Address Fax Number:
804-353-3342

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
204 N HAMILTON ST
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23221-2662
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-353-1230
Provider Business Practice Location Address Fax Number:
804-353-3342
Provider Enumeration Date:
03/28/2014

Additional Information

Authorized Official

Authorized Official Last Name:
GIFFORD
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
804-307-0818

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  0101037152 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QA0401X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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