MEDICARE: HOUSECALLS OF VIRGINIA

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	207QG0300X	Geriatric Medicine (Family Medicine) Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346436797
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSECALLS OF VIRGINIA

Provider Business Mailing Address
First Line	:	7323 BOULDER VIEW LN
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23225-4953
Country	:	US
Telephone Number	:	804-245-4713
Fax Number	:	804-744-8811

Provider Business Practice Location Address
First Line	:	7323 BOULDER VIEW LN
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23225-4953
Country	:	US
Telephone Number	:	804-245-4713
Fax Number	:	804-744-8811

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. WILLIAM H. SNODGRASS
Credential	:
Telephone Number	:	804-745-0054

Provider Enumeration Date	:	09/19/2007
Last Update Date	:	06/30/2010

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