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General NPI Number Information
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NPI Number | 1801319587
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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 | 07/25/2017
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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 STE 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 | 804-673-2731
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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 | 804-391-4171
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Fax | 804-200-6229
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | TABATHA FARMER
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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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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