Healthcare Provider Details

I. General information

NPI: 1447940523
Provider Name (Legal Business Name): NUEROHEALTH SOLUTIONS OF VA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2023
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 WESTERRE PKWY STE 300
RICHMOND VA
23233-1339
US

IV. Provider business mailing address

3900 WESTERRE PKWY STE 300
RICHMOND VA
23233-1339
US

V. Phone/Fax

Practice location:
  • Phone: 877-465-4384
  • Fax: 877-465-4384
Mailing address:
  • Phone: 877-465-4384
  • Fax: 877-465-4384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERT M ROTH
Title or Position: MGR/MEMBER
Credential: ESQ.
Phone: 877-465-4384