MEDICARE: UROLOGY OF VIRGINIA PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1851429468
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UROLOGY OF VIRGINIA PC

Provider Business Mailing Address
First Line	:	PO BOX 13208
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23506-0208
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 FIRST COLONIAL RD STE 100G
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-2264
Country	:	US
Telephone Number	:	757-481-3556
Fax Number	:

Authorized Official
Title or Position	:	CBO MANAGER
Name	:	LORI DELBRIDGE
Credential	:
Telephone Number	:	757-466-3410

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	11/20/2007

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