Provider Demographics
NPI:1689788390
Name:RICHMOND PEDIATRIC ASSOCIATES, INC.
Entity Type:Organization
Organization Name:RICHMOND PEDIATRIC ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GALYEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-747-1750
Mailing Address - Street 1:9900 INDEPENDENCE PARK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1473
Mailing Address - Country:US
Mailing Address - Phone:804-747-1855
Mailing Address - Fax:804-762-8837
Practice Address - Street 1:9900 INDEPENDENCE PARK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-1473
Practice Address - Country:US
Practice Address - Phone:804-747-1855
Practice Address - Fax:804-762-8837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA=========OtherTIN