Healthcare Provider Details

I. General information

NPI: 1285815167
Provider Name (Legal Business Name): HY-TECH ELECTRICAL CONSTRUCTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2007
Last Update Date: 11/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 WATCHRUN DR
RICHMOND VA
23234-6113
US

IV. Provider business mailing address

4301 WATCHRUN DR
RICHMOND VA
23234-6113
US

V. Phone/Fax

Practice location:
  • Phone: 804-279-8755
  • Fax:
Mailing address:
  • Phone: 804-279-8755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number2705115644A
License Number StateVA

VIII. Authorized Official

Name: EDWARD KELLEY
Title or Position: OWNER
Credential:
Phone: 804-279-8755