Healthcare Provider Details

I. General information

NPI: 1447619390
Provider Name (Legal Business Name): USIHEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2016
Last Update Date: 02/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 QUAIL POINT RD
VIRGINIA BEACH VA
23454-3117
US

IV. Provider business mailing address

1616 QUAIL POINT RD
VIRGINIA BEACH VA
23454-3117
US

V. Phone/Fax

Practice location:
  • Phone: 757-770-0788
  • Fax:
Mailing address:
  • Phone: 757-770-0788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JOHN FRANCIS GALLAGHER III
Title or Position: CEO
Credential:
Phone: 757-770-0788