Provider Demographics
NPI:1629144522
Name:PENNYRICH CREATIONS INC
Entity Type:Organization
Organization Name:PENNYRICH CREATIONS INC
Other - Org Name:RAYLENE'S PENNYRICH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAYLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-358-7313
Mailing Address - Street 1:3016 W CARY ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-3502
Mailing Address - Country:US
Mailing Address - Phone:804-358-7313
Mailing Address - Fax:804-353-9946
Practice Address - Street 1:3016 W CARY ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23221-3502
Practice Address - Country:US
Practice Address - Phone:804-358-7313
Practice Address - Fax:804-353-9946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0746120001Medicare ID - Type Unspecified