Organization
VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY
Active
Other names
VCU Health Neuroscience,Orthopaedic and Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN DUVAL (CEO)
(804) 828-0938
Entity
Organization
Contact information
Practice address
11958 W BROAD ST, HENRICO, VA 23233-1007
(804) 628-6643
Mailing address
PO BOX 758997, BALTIMORE, MD 21275-8997
(804) 628-6643
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
H1875
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00003
ANTHEM
VA
Enumeration date
06/08/2016
Last updated
06/08/2016
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