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Organization

CRIPPLED CHILDREN'S HOSPITAL

Active
Other names
Children's Hospital
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LESLIE G. WYATT RN, MS (PRESIDENT/CEO)
(804) 321-7474
Entity
Organization

Contact information

Practice address
2924 BROOK RD, RICHMOND, VA 23220-1215
(804) 321-7474
(804) 321-2728
Mailing address
2924 BROOK RD, RICHMOND, VA 23220-1215
(804) 321-7474
(804) 321-2728

Taxonomy

Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
H1627
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004909976
VA
05
004939972
VA
05
004960777
VA
01
C09422
MEDICARE PART B
VA
Enumeration date
05/03/2006
Last updated
05/26/2009
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