Provider Demographics
NPI:1033663786
Name:HENRICO DOCTORS HOSPITAL
Entity Type:Organization
Organization Name:HENRICO DOCTORS HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:804-545-4952
Mailing Address - Street 1:7650 E PARHAM RD
Mailing Address - Street 2:120
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4373
Mailing Address - Country:US
Mailing Address - Phone:804-545-4952
Mailing Address - Fax:
Practice Address - Street 1:7650 E PARHAM RD
Practice Address - Street 2:120
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4373
Practice Address - Country:US
Practice Address - Phone:804-545-4952
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305208142283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital