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General NPI Number Information
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NPI Number | 1750515094
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Entity Type | Organization
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Legal Business Name | MARCS AGENCY LLC
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Dates
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Enumeration Date | 05/13/2009
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Last Update Date | 02/05/2014
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Provider Practice Location Address
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Address Line | 219 E CLAY ST SUITE C
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City | RICHMOND
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State | VA
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Zip | 23219-1354
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Country | US
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Telephone | 804-301-8403
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 26203
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City | RICHMOND
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State | VA
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Zip | 23260-6203
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Country | US
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Telephone | 804-301-8403
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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. MICHAEL WIGGINS JR.
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Credential |
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Telephone | 804-301-8403
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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 | 1429-05-001
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License Number State | VA
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