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Organization

VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY

Active
Other names
VCU Health System - Speciality Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
ELIZABETH ALLEN (VP FINANCE AND ACCOUNTING)
(804) 628-1338
Entity
Organization

Contact information

Practice address
1030 WILMER AVE STE 300, RICHMOND, VA 23227-2403
(877) 814-3475
(804) 364-6585
Mailing address
PO BOX 758997, BALTIMORE, MD 21275-0001
(804) 628-6643

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336C0003X
Community/Retail Pharmacy
0202211458
VA
3336S0011X
Specialty Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30015174800079
VA
Enumeration date
07/19/2017
Last updated
10/03/2022
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