MEDICARE: VIRGINIA UROLOGY CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	0419750002	VA
2	332900000X	Non-Pharmacy Dispensing Site

General Provider Information

NPI Number	:	1043275977
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRGINIA UROLOGY CENTER

Provider Business Mailing Address
First Line	:	9101 STONY POINT PKWY
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23235-2002
Country	:	US
Telephone Number	:	804-287-1030
Fax Number	:	804-288-3529

Provider Business Practice Location Address
First Line	:	8152 PLEASANT GROVE RD
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23116-2343
Country	:	US
Telephone Number	:	804-730-5023
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. BRIGETTE BOOTH
Credential	:
Telephone Number	:	804-330-9105

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	06/16/2022

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Directions to “VIRGINIA UROLOGY CENTER ” Practice Location

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