MEDICARE: CENTRAL VIRGINIA HEALTH SERVICES INC

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	261QF0400X	Federally Qualified Health Center (FQHC)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902934680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL VIRGINIA HEALTH SERVICES INC

Provider Business Mailing Address
First Line	:	PO BOX 220
Second Line	:
City	:	NEW CANTON
State	:	VA
Zip	:	23123-0220
Country	:	US
Telephone Number	:	434-581-4073
Fax Number	:

Provider Business Practice Location Address
First Line	:	4260 CROSSINGS BLVD
Second Line	:	SUITE 2
City	:	PRINCE GEORGE
State	:	VA
Zip	:	23875-1400
Country	:	US
Telephone Number	:	434-542-5560
Fax Number	:	434-542-5745

Authorized Official
Title or Position	:	CFO
Name	:	CHARLES ALLBAUGH
Credential	:
Telephone Number	:	434-581-4073

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	12/16/2019

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