Organization
BUFORD ROAD IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT F CARREL (AUTHORIZED OFFICIAL)
(804) 267-2958
Entity
Organization
Contact information
Practice address
2612 BUFORD ROAD, RICHMOND, VA 23235-3422
(804) 864-1895
(804) 377-3419
Mailing address
2612 BUFORD ROAD, RICHMOND, VA 23235-3422
(804) 864-1895
(804) 377-3419
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
010144531
VA
261QR0206X
Mammography Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10144531
—
VA
01
—
442572
ANTHEM BCBS
VA
Enumeration date
06/02/2006
Last updated
12/14/2015
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