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Organization

VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY

Active
Other names
VCU Health Orthopedics at South Park
Organization subpart
No

Provider details

NPI number
Authorized official
MELINDA SUMMERLIN HANCOCK (CFO)
(804) 628-3343
Entity
Organization

Contact information

Practice address
325 CHARLES H DIMMOCK PKWY STE 100, COLONIAL HEIGHTS, VA 23834-2986
(804) 526-5888
Mailing address
PO BOX 758997, BALTIMORE, MD 21275-0001
(804) 628-6643

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000003
ANTHEM
VA
Enumeration date
06/28/2019
Last updated
06/28/2019
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