# PREMISE HEALTH OF VIRGINIA MEDICAL, P.C

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CHS HEALTH SERVICE, LLC
- **Other names:** Altria Health Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1023360112
- **Legal business name:** CHS HEALTH SERVICE, LLC
- **Authorized official:** JON LEIZMAN (PRESIDENT)
- **Authorized official phone:** (216) 479-9063

## Contact information

- **Practice address:** 6601 W BROAD ST, RICHMOND, VA 23230-1723
- **Practice address phone:** (804) 484-8891
- **Mailing address:** 5500 MARYLAND WAY, STE 400, BRENTWOOD, TN 37027-4948

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/12/2012
- **Last updated:** 08/15/2022