MEDICARE: UROLOGY OF VIRGINIA, PC

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

General Provider Information

NPI Number	:	1174651293
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UROLOGY OF VIRGINIA, PC

Provider Business Mailing Address
First Line	:	6333 CENTER DR BLDG 16
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23502-4126
Country	:	US
Telephone Number	:	757-466-0800
Fax Number	:

Provider Business Practice Location Address
First Line	:	6333 CENTER DR BLDG 16
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23502-4126
Country	:	US
Telephone Number	:	757-466-0800
Fax Number	:

Authorized Official
Title or Position	:	CBO DIRECTOR
Name	:	LORI DELBRIDGE
Credential	:
Telephone Number	:	757-466-3410

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	11/20/2007

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