Healthcare Provider Details

I. General information

NPI: 1932691953
Provider Name (Legal Business Name): CENTRAL VIRGINIA HEALTH SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2018
Last Update Date: 06/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321C POPLAR DR
PETERSBURG VA
23805-9306
US

IV. Provider business mailing address

321C POPLAR DR
PETERSBURG VA
23805-9306
US

V. Phone/Fax

Practice location:
  • Phone: 804-733-5591
  • Fax: 804-957-5850
Mailing address:
  • Phone: 804-733-5591
  • Fax: 804-957-5850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number0201001944
License Number StateVA

VIII. Authorized Official

Name: DAVID WARE CHRISTIAN
Title or Position: PHARMACY DIRECTOR
Credential:
Phone: 434-581-3271