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General NPI Number Information
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NPI Number | 1568449858
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Entity Type | Organization
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Legal Business Name | COMMUNITY RADIOLOGY OF VIRGINIA, INC
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 06/12/2017
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Provider Practice Location Address
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Address Line | 2000 LEATHERWOOD LN
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City | BLUEFIELD
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State | VA
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Zip | 24605-2020
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Country | US
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Telephone | 276-326-1215
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Fax | 276-326-1518
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Provider Business Mailing Address
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Address Line | 2000 LEATHERWOOD LANE
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City | BLUEFIELD
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State | VA
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Zip | 24605-2020
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Country | US
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Telephone | 304-327-7177
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Fax | 304-327-5850
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | GARY WRIGHT
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Credential |
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Telephone | 813-977-8756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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