Healthcare Provider Details
I. General information
NPI: 1861791766
Provider Name (Legal Business Name): PATIENT FIRST RICHMOND MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/18/2011
Last Update Date: 01/27/2021
Certification Date: 01/27/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1260 TEMPLE AVENUE
COLONIAL HEIGHTS VA
23834-2984
US
IV. Provider business mailing address
5000 COX RD
GLEN ALLEN VA
23060-9263
US
V. Phone/Fax
- Phone: 804-518-2597
- Fax: 804-518-2598
- Phone: 804-968-5700
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
GEORGE
H.
MORISON
Title or Position: PRESIDENT
Credential:
Phone: 804-968-5700