Healthcare Provider Details

I. General information

NPI: 1629030812
Provider Name (Legal Business Name): CASE MANAGEMENT ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5310 MARKEL RD SUITE 108
RICHMOND VA
23230-3030
US

IV. Provider business mailing address

5310 MARKEL RD SUITE 108
RICHMOND VA
23230-3030
US

V. Phone/Fax

Practice location:
  • Phone: 804-282-2668
  • Fax: 804-282-0056
Mailing address:
  • Phone: 804-282-2668
  • Fax: 804-497-1228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number0101057836
License Number StateVA

VIII. Authorized Official

Name: DR. VERA Y GENINA
Title or Position: MEDICAL DIRECTOR
Credential: MD, PHD
Phone: 804-873-8389