Healthcare Provider Details

I. General information

NPI: 1952405219
Provider Name (Legal Business Name): PCH OPERATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2006
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18688 JEB STUART HWY
STUART VA
24171-1559
US

IV. Provider business mailing address

18688 JEB STUART HIGHWAY
STUART VA
24171
US

V. Phone/Fax

Practice location:
  • Phone: 276-694-3151
  • Fax: 276-694-8655
Mailing address:
  • Phone: 276-694-3151
  • Fax: 276-694-8655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. JANICE F WILKINS
Title or Position: ADMINISTRATOR
Credential:
Phone: 276-694-8678