Provider Demographics
NPI:1326594524
Name:VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM
Entity Type:Organization
Organization Name:VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM
Other - Org Name:VCUHS
Other - Org Type:Other Name
Authorized Official - Title/Position:INPATIENT PSYCHIATRY CHAIR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANANDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:PANDURANGI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-828-4570
Mailing Address - Street 1:1300 E. MARSHALL STREET
Mailing Address - Street 2:SUITE 275 3RD F
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1300 E. MARSHALL STREET
Practice Address - Street 2:SUITE 275 3RD F
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298
Practice Address - Country:US
Practice Address - Phone:804-914-1729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024173800273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit