Provider Demographics
NPI:1740594332
Name:VIRGINIA WOMENS CENTER INC
Entity Type:Organization
Organization Name:VIRGINIA WOMENS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:K
Authorized Official - Last Name:STOUT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-288-4084
Mailing Address - Street 1:7130 GLEN FOREST DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3754
Mailing Address - Country:US
Mailing Address - Phone:804-288-4084
Mailing Address - Fax:804-282-8678
Practice Address - Street 1:7130 GLEN FOREST DR
Practice Address - Street 2:SUITE 101
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3754
Practice Address - Country:US
Practice Address - Phone:804-288-4084
Practice Address - Fax:804-282-8678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-06
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVAA113131Medicare PIN