Healthcare Provider Details

I. General information

NPI: 1841123106
Provider Name (Legal Business Name): COLUMBIA/HCA JOHN RANDOLPH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 SOUTH AVE STE 2
COLONIAL HEIGHTS VA
23834-3620
US

IV. Provider business mailing address

930 SOUTH AVE STE 2
COLONIAL HEIGHTS VA
23834-3620
US

V. Phone/Fax

Practice location:
  • Phone: 804-520-8272
  • Fax:
Mailing address:
  • Phone: 804-520-8272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH MAZZO
Title or Position: CEO
Credential:
Phone: 804-514-7732