Provider Demographics
NPI:1295723195
Name:THOMAS G. POWELL, INC.
Entity type:Organization
Organization Name:THOMAS G. POWELL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORP SEC. TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:MONTEIRO
Authorized Official - Suffix:SR
Authorized Official - Credentials:CP
Authorized Official - Phone:804-649-9043
Mailing Address - Street 1:2034 DABNEY RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3361
Mailing Address - Country:US
Mailing Address - Phone:804-649-9043
Mailing Address - Fax:804-783-8212
Practice Address - Street 1:2034 DABNEY RD
Practice Address - Street 2:SUITE C
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3361
Practice Address - Country:US
Practice Address - Phone:804-649-9043
Practice Address - Fax:804-783-8212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-13
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0004385092OtherAETNA
VA009190082Medicaid
VA87OtherCARENET
VA148785100OtherUS DEPT OF LABOR
VA9190082OtherVIRGINIA PREMEIR HP
VA63730OtherSOUTHERN HEALTH
VAAN01OtherAMERICAN CHOICE HP
VA2056388OtherCIGNA
VA252386OtherMDPIA
VA82-00022OtherUNITED HEALTHCARE
VA009130004Medicaid
VA062896OtherANTHEM
VA51951OtherOPTIMA