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General NPI Number Information
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NPI Number | 1710017108
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Entity Type | Organization
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Legal Business Name | VIRGINIA CANCER INSITUTE WEST END
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 05/20/2021
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Provider Practice Location Address
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Address Line | 6605 W BROAD ST SUITE A
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City | RICHMOND
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State | VA
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Zip | 23230-1714
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Country | US
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Telephone | 804-287-3000
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Fax | 804-282-3314
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Provider Business Mailing Address
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Address Line | 6605 W BROAD ST SUITE A
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City | RICHMOND
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State | VA
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Zip | 23230-1714
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Country | US
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Telephone | 804-287-3000
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Fax | 804-282-3314
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Authorized Official
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Title or Position | CREDENTIALS
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Name | TABATHA FARMER III
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Credential |
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Telephone | 804-391-4171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | 0201003994
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License Number State | VA
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