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General NPI Number Information
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NPI Number | 1770936650
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Entity Type | Organization
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Legal Business Name | VIRGINIA CANCER INSTITUTE INCORPORATED
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Dates
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Enumeration Date | 07/15/2016
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Last Update Date | 06/16/2022
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Provider Practice Location Address
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Address Line | 8007 DISCOVERY DR STE A
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City | RICHMOND
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State | VA
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Zip | 23229-8605
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Country | US
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Telephone | 804-287-3000
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Fax | 804-673-2731
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Provider Business Mailing Address
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Address Line | 7202 GLEN FOREST DR STE 200
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City | RICHMOND
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State | VA
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Zip | 23226-3780
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Country | US
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Telephone | 804-673-2024
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Fax | 804-673-1796
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Authorized Official
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Title or Position | PRESIDENT
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Name | PABLO GONZALEZ
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Credential | MD
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Telephone | 804-330-7990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 0201004713
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License Number State | VA
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