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General NPI Number Information
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NPI Number | 1194040766
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Entity Type | Organization
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Legal Business Name | RICHMOND MEDICAL GROUP
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Dates
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Enumeration Date | 04/07/2010
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Last Update Date | 01/05/2021
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Provider Practice Location Address
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Address Line | 3031 PLANK RD
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-4951
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Country | US
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Telephone | 540-736-5043
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Fax | 540-736-5044
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Provider Business Mailing Address
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Address Line | 3031 PLANK RD
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-4951
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Country | US
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Telephone | 540-736-5043
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Fax | 540-736-5044
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Authorized Official
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Title or Position | DIR. OF PHARMACY
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Name | MR. MARVIN WARREN BRIDGERS III
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Credential | RPH
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Telephone | 804-822-4383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 213000653
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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