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General NPI Number Information
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NPI Number | 1578257713
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Entity Type | Organization
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Legal Business Name | INDIAN HEALTH SERVICE RICHMOND SERVICE UNIT
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Dates
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Enumeration Date | 06/08/2023
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Last Update Date | 03/20/2024
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Provider Practice Location Address
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Address Line | 108 DIXIE AIRPORT RD.
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City | MADISON HEIGHTS
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State | VA
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Zip | 24572-5973
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Country | US
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Telephone | 804-622-0011
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Fax | 804-622-0010
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Provider Business Mailing Address
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Address Line | 108 DIXIE AIRPORT RD.
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City | MADISON HEIGHTS
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State | VA
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Zip | 24572-5973
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Country | US
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Telephone | 804-622-0011
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Fax | 804-622-0010
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Authorized Official
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Title or Position | ADMINSTRATIVE OFFICER
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Name | REMEDIOS DEE HOLMES
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Credential |
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Telephone | 804-622-0011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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