Provider Demographics
NPI:1659919504
Name:RICHMOND CITY SHERIFF'S OFFICE
Entity Type:Organization
Organization Name:RICHMOND CITY SHERIFF'S OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SHERIFF OF RICHMOND CITY
Authorized Official - Prefix:MS
Authorized Official - First Name:ANTIONETTE
Authorized Official - Middle Name:V
Authorized Official - Last Name:IRVING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:804-646-0140
Mailing Address - Street 1:1701 FAIRFIELD WAY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223
Mailing Address - Country:US
Mailing Address - Phone:804-646-0048
Mailing Address - Fax:
Practice Address - Street 1:1701 FAIRFIELD WAY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223
Practice Address - Country:US
Practice Address - Phone:804-646-0048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-11
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health