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General NPI Number Information
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NPI Number | 1164138996
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Entity Type | Organization
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Legal Business Name | SOZO HEALTHCARE, LLC
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Dates
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Enumeration Date | 01/25/2023
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Last Update Date | 01/25/2023
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Provider Practice Location Address
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Address Line | 508 WATERWORKS RD
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City | FARMVILLE
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State | VA
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Zip | 23901-2674
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Country | US
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Telephone | 434-394-3433
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Fax |
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Provider Business Mailing Address
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Address Line | 5607 GROVE AVE
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City | RICHMOND
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State | VA
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Zip | 23226-2101
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Country | US
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Telephone | 434-395-8115
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. JEFFREY D CRAWFORD
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Credential |
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Telephone | 434-395-8115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2400X
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Taxonomy Name | Prison Health Clinic/Center
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License Number |
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License Number State |
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