Provider Demographics
NPI:1467672212
Name:VIRGINIA NUCLEAR CARDIOLOGY PLC
Entity Type:Organization
Organization Name:VIRGINIA NUCLEAR CARDIOLOGY PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUIDRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-815-7804
Mailing Address - Street 1:10720 SIKES PL
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-8141
Mailing Address - Country:US
Mailing Address - Phone:704-815-7789
Mailing Address - Fax:888-401-6931
Practice Address - Street 1:3301 WOODBURN RD
Practice Address - Street 2:SUITE 304
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-1229
Practice Address - Country:US
Practice Address - Phone:703-204-0355
Practice Address - Fax:703-204-0356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225B00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPulmonary Function TechnologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCP00289400OtherRR MEDICARE
DCG01196Medicare PIN
DCP00289400OtherRR MEDICARE