Provider Demographics
NPI:1508049701
Name:RICHMOND EYE ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:RICHMOND EYE ASSOCIATES, P.C.
Other - Org Name:RICHMOND EYE OPTICAL-COLD HARBOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALDACCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-270-0330
Mailing Address - Street 1:4600 COX RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-6753
Mailing Address - Country:US
Mailing Address - Phone:804-270-0330
Mailing Address - Fax:
Practice Address - Street 1:7575 COLD HARBOR RD
Practice Address - Street 2:BLDG. 2, SUITE 1-B
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-1600
Practice Address - Country:US
Practice Address - Phone:804-746-1125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1101001718332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0699610003Medicare NSC