Provider Demographics
NPI:1659038990
Name:F.C. OF VIRGINIA, INC.
Entity Type:Organization
Organization Name:F.C. OF VIRGINIA, INC.
Other - Org Name:INTREPID USA HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CCO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-445-3773
Mailing Address - Street 1:3220 KELLER SPRINGS RD STE 108
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-5911
Mailing Address - Country:US
Mailing Address - Phone:214-445-3750
Mailing Address - Fax:
Practice Address - Street 1:3700 FESTIVAL PARK PLZ # 3A
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-4415
Practice Address - Country:US
Practice Address - Phone:804-768-9080
Practice Address - Fax:804-768-9011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-22
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health