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General NPI Number Information
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NPI Number | 1659953636
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Entity Type | Organization
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Legal Business Name | VCU HEALTH AMBULATORY SURGERY CENTER, LLC
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Dates
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Enumeration Date | 04/28/2021
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Last Update Date | 11/07/2023
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Provider Practice Location Address
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Address Line | 11958 W BROAD ST FL 5
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City | HENRICO
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State | VA
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Zip | 23233-1007
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Country | US
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Telephone | 804-364-6640
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Fax |
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Provider Business Mailing Address
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Address Line | 7818 E PARHAM RD FL 3
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City | RICHMOND
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State | VA
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Zip | 23294-4302
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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 | CHIEF FINANCIAL OFFICER
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Name | MR. JAMES SIEGEL
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Credential |
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Telephone | 804-628-1624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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