Organization
COMMONWEALTH CARE SERVICES LLC
Active
Organization
COMMONWEALTH CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOVAT C BATES (OWNER)
(804) 919-1126
Entity
Organization
Contact information
Practice address
444 PINE RIDGE RD, PETERSBURG, VA 23805-1320
(804) 919-1126
Mailing address
444 PINE RIDGE RD, PETERSBURG, VA 23805-1320
(804) 919-1126
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
2059-010001
VA
Other
Enumeration date
04/10/2014
Last updated
04/10/2014
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