Healthcare Provider Details

I. General information

NPI: 1497935365
Provider Name (Legal Business Name): COMMONWEALTH HOSP SVCS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2007
Last Update Date: 09/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1602 SKIPWITH RD
RICHMOND VA
23229-5205
US

IV. Provider business mailing address

4050 INNSLAKE DR SUITE 308
GLEN ALLEN VA
23060-3327
US

V. Phone/Fax

Practice location:
  • Phone: 804-289-4951
  • Fax: 804-289-5623
Mailing address:
  • Phone: 804-521-5315
  • Fax: 804-521-5312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SPRING WILLIAMS
Title or Position: ADMINISTRATOR
Credential:
Phone: 804-521-5315