Provider Demographics
NPI:1932500485
Name:COLUMBIA/HCA JOHN RANDOLPH, INC.
Entity Type:Organization
Organization Name:COLUMBIA/HCA JOHN RANDOLPH, INC.
Other - Org Name:COLONIAL HEIGHTS SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MAREK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-452-3650
Mailing Address - Street 1:930 SOUTH AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-3621
Mailing Address - Country:US
Mailing Address - Phone:804-520-8272
Mailing Address - Fax:866-847-5160
Practice Address - Street 1:930 SOUTH AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-3621
Practice Address - Country:US
Practice Address - Phone:804-520-8272
Practice Address - Fax:866-847-5160
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLUMBIA/HCA JOHN RANDOLPH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-15
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical