Healthcare Provider Details

I. General information

NPI: 1831441781
Provider Name (Legal Business Name): CARELON HEALTH OF VIRGINIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2012
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5620 BROOK RD
RICHMOND VA
23227
US

IV. Provider business mailing address

12900 PARK PLAZA DR SUITE 150
CERRITOS CA
90703-9329
US

V. Phone/Fax

Practice location:
  • Phone: 804-767-8400
  • Fax: 804-262-5113
Mailing address:
  • Phone: 888-291-1358
  • Fax: 562-977-6141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY ALBION
Title or Position: PRESIDENT/CEO
Credential:
Phone: 603-268-5146