Healthcare Provider Details

I. General information

NPI: 1538486063
Provider Name (Legal Business Name): RICHMOND CITY HEALTH DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 05/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E CARY ST
RICHMOND VA
23219-3816
US

IV. Provider business mailing address

400 E CARY ST
RICHMOND VA
23219-3816
US

V. Phone/Fax

Practice location:
  • Phone: 804-205-3500
  • Fax:
Mailing address:
  • Phone: 804-205-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number0024168287
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number0024168287
License Number StateVA

VIII. Authorized Official

Name: MR. MARGARET TEU
Title or Position: CERTIFIED NURSE PRACTITIONER
Credential: NP
Phone: 804-205-3741