Healthcare Provider Details

I. General information

NPI: 1689226854
Provider Name (Legal Business Name): RUBIES HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 08/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 COWARDIN AVE STE 101B
RICHMOND VA
23224-2078
US

IV. Provider business mailing address

101 COWARDIN AVE STE 101
RICHMOND VA
23224-2078
US

V. Phone/Fax

Practice location:
  • Phone: 804-219-9646
  • Fax:
Mailing address:
  • Phone: 804-420-8650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ALIA R DIXON
Title or Position: FAMILY MEDICINE NURSE PRACTITIONER
Credential: FNP-BC
Phone: 804-420-8650