Provider Demographics
NPI:1710282827
Name:RIVER'S WAY HEALTHCARE OF VIRGINIA PLLC
Entity Type:Organization
Organization Name:RIVER'S WAY HEALTHCARE OF VIRGINIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-658-0435
Mailing Address - Street 1:1791 CAMBRIDGE DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23238-5839
Mailing Address - Country:US
Mailing Address - Phone:804-658-0435
Mailing Address - Fax:804-562-8584
Practice Address - Street 1:1791 CAMBRIDGE DR
Practice Address - Street 2:SUITE 203
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238-5839
Practice Address - Country:US
Practice Address - Phone:804-658-0435
Practice Address - Fax:804-562-8584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101044021207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty