Healthcare Provider Details

I. General information

NPI: 1891823498
Provider Name (Legal Business Name): CENTRAL VIRGINIA HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 12/16/2019
Certification Date: 12/16/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 LEGRANDE AVENUE
CHARLOTTE COURTHOUSE VA
23923
US

IV. Provider business mailing address

PO BOX 220
NEW CANTON VA
23123-0220
US

V. Phone/Fax

Practice location:
  • Phone: 434-542-5560
  • Fax: 434-542-5745
Mailing address:
  • Phone: 434-581-4073
  • Fax: 434-581-1704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: CHARLES ALLBAUGH
Title or Position: CFO
Credential:
Phone: 434-581-4073