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General NPI Number Information
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NPI Number | 1639878465
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Entity Type | Organization
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Legal Business Name | VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER
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Dates
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Enumeration Date | 03/01/2023
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Last Update Date | 03/01/2023
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Provider Practice Location Address
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Address Line | 719 N 25TH ST STE 101
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City | RICHMOND
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State | VA
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Zip | 23223-6539
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Country | US
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Telephone | 804-215-2938
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Fax | 804-942-0203
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Provider Business Mailing Address
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Address Line | 1620 W NORTHWEST HWY STE 100
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City | GRAPEVINE
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State | TX
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Zip | 76051-3219
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Country | US
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Telephone | 817-913-7247
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Fax | 817-720-1039
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Authorized Official
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Title or Position | CEO
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Name | TRACY CAUSEY
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Credential |
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Telephone | 804-253-1968
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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