Provider Demographics
NPI:1659926715
Name:CONEXUS
Entity Type:Organization
Organization Name:CONEXUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:HOPE
Authorized Official - Last Name:MEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-423-2020
Mailing Address - Street 1:11618 BUSY ST
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-4060
Mailing Address - Country:US
Mailing Address - Phone:804-423-2020
Mailing Address - Fax:804-423-5409
Practice Address - Street 1:11618 BUSY ST
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-4060
Practice Address - Country:US
Practice Address - Phone:804-423-2020
Practice Address - Fax:804-423-5409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Single Specialty