Healthcare Provider Details

I. General information

NPI: 1073646501
Provider Name (Legal Business Name): RETREAT CARDIOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 JAHNKE RD STE 550
RICHMOND VA
23225-4017
US

IV. Provider business mailing address

2000 HEALTH PARK DR
BRENTWOOD TN
37027-4692
US

V. Phone/Fax

Practice location:
  • Phone: 804-560-8880
  • Fax:
Mailing address:
  • Phone: 615-373-7406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE BERGAMO
Title or Position: VP
Credential:
Phone: 804-267-5950