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General NPI Number Information
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NPI Number | 1609367796
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Entity Type | Organization
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Legal Business Name | BRANDSYNC BENEFIT CORPORATION
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Dates
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Enumeration Date | 05/23/2018
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Last Update Date | 05/23/2018
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Provider Practice Location Address
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Address Line | 9327 MIDLOTHIAN TPKE STE 2A
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-4944
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Country | US
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Telephone | 804-314-2180
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Fax | 804-237-0198
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Provider Business Mailing Address
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Address Line | 4210 NEW KENT AVE
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City | RICHMOND
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State | VA
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Zip | 23225-3339
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Country | US
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Telephone | 804-314-2180
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Fax | 804-237-0198
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT WILLIAMS MARTIN
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Credential | MSW
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Telephone | 804-314-2180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0904002765
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License Number State | VA
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