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General NPI Number Information
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NPI Number | 1407811359
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Entity Type | Organization
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Legal Business Name | VIRGINIA UROLOGY CENTER
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Dates
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Enumeration Date | 04/20/2006
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Last Update Date | 02/09/2010
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Provider Practice Location Address
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Address Line | 9351 WEST BOARD ST
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City | RICHMOND
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State | VA
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Zip | 23294-1999
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Country | US
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Telephone | 804-288-4137
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Fax |
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Provider Business Mailing Address
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Address Line | 9105 STONY POINT DR
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City | RICHMOND
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State | VA
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Zip | 23235-1999
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. TERRY COFFEY
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Credential |
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Telephone | 804-287-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0419750001
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License Number State | VA
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