Provider Demographics
NPI:1740611847
Name:HENRICO FAMILY PHYSICIANS, LLC
Entity Type:Organization
Organization Name:HENRICO FAMILY PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:V
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-346-3077
Mailing Address - Street 1:PO BOX 896127
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28289-6127
Mailing Address - Country:US
Mailing Address - Phone:804-346-3077
Mailing Address - Fax:
Practice Address - Street 1:3460 MAYLAND CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-1449
Practice Address - Country:US
Practice Address - Phone:804-346-3077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH DIAGNOSTIC LABORATORY, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-29
Last Update Date:2013-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101049639207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty