Provider Demographics
NPI:1407193105
Name:AWAD CONCRETE CONSTRUCTION INC.
Entity Type:Organization
Organization Name:AWAD CONCRETE CONSTRUCTION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:AWAD
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:804-355-5146
Mailing Address - Street 1:4109 STUART AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-1940
Mailing Address - Country:US
Mailing Address - Phone:804-355-5146
Mailing Address - Fax:804-359-1141
Practice Address - Street 1:4109 STUART AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23221-1940
Practice Address - Country:US
Practice Address - Phone:804-355-5146
Practice Address - Fax:804-359-1141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2705068358171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty