Provider Demographics
NPI:1639878465
Name:VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER
Entity Type:Organization
Organization Name:VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAUSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-253-1968
Mailing Address - Street 1:1620 W NORTHWEST HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-3219
Mailing Address - Country:US
Mailing Address - Phone:817-913-7247
Mailing Address - Fax:817-720-1039
Practice Address - Street 1:719 N 25TH ST STE 101
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-6539
Practice Address - Country:US
Practice Address - Phone:804-215-2938
Practice Address - Fax:804-942-0203
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy