Healthcare Provider Details

I. General information

NPI: 1144378704
Provider Name (Legal Business Name): PATIENT FIRST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 N BATTLEFIELD BLVD
CHESAPEAKE VA
23320
US

IV. Provider business mailing address

5000 COX RD STE 100
GLEN ALLEN VA
23060-9263
US

V. Phone/Fax

Practice location:
  • Phone: 757-547-0688
  • Fax: 757-547-2902
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number StateVA

VIII. Authorized Official

Name: PAM PHELAN
Title or Position: DMS
Credential: RN
Phone: 757-547-0688