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Organization
COMMONWEALTH PRIMARY CARE
Active
Organization
COMMONWEALTH PRIMARY CARE
Active
Other names
Family Physicians, Wyndham
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ERIKA PARRISH (BILLING ADMIN)
(804) 288-0399
Entity
Organization
Contact information
Practice address
5360 TWIN HICKORY RD, GLEN ALLEN, VA 23059-5682
(804) 346-3200
(804) 346-4075
Mailing address
1800 GLENSIDE DR, SUITE 105, RICHMOND, VA 23226-3769
(804) 288-0399
(804) 285-0088
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141466
ANTHEM
VA
01
—
CJ7063
RAILROAD MEDICARE
VA
Enumeration date
11/16/2006
Last updated
09/16/2011
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