Healthcare Provider Details

I. General information

NPI: 1821168915
Provider Name (Legal Business Name): CAPITAL HEALTHCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1513 IDLEWOOD AVE
RICHMOND VA
23220-6005
US

IV. Provider business mailing address

PO BOX 394
RICHMOND VA
23218-0394
US

V. Phone/Fax

Practice location:
  • Phone: 804-475-6234
  • Fax: 804-355-5962
Mailing address:
  • Phone: 804-475-6234
  • Fax: 804-355-5962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number0001107471
License Number StateVA

VIII. Authorized Official

Name: MS. SHARILYN B. ROBINSON
Title or Position: DIRECTOR
Credential: R.N.
Phone: 804-475-6234