Organization
COMMONWEALTH PRIMARY CARE
Active
Parent organization
COMMONWEALTH PRIMARY CARE
Other names
CPC Rehabilitation Division
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMONWEALTH PRIMARY CARE
Authorized official
MS. CHERYL DANIEL (BILLING MANAGER)
(804) 288-0399
Entity
Organization
Contact information
Practice address
4050 INNSLAKE DR STE 308, GLEN ALLEN, VA 23060
(804) 521-5310
(804) 521-5312
Mailing address
8002 DISCOVERY DR STE 410, RICHMOND, VA 23229
(804) 288-0399
(804) 288-0088
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139440
ANTHEM
VA
01
—
CC6597
MEDICARE RR
VA
Enumeration date
01/19/2007
Last updated
12/18/2007
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