Provider Demographics
NPI:1700445673
Name:VIRGINIA HEALTHCARE, PC
Entity Type:Organization
Organization Name:VIRGINIA HEALTHCARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALTORY
Authorized Official - Middle Name:MUSNI
Authorized Official - Last Name:MIRANDA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:804-554-6134
Mailing Address - Street 1:PO BOX 17830
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-7830
Mailing Address - Country:US
Mailing Address - Phone:804-554-6134
Mailing Address - Fax:804-681-7102
Practice Address - Street 1:16313 FALCONERS TER
Practice Address - Street 2:
Practice Address - City:MOSELEY
Practice Address - State:VA
Practice Address - Zip Code:23120-1655
Practice Address - Country:US
Practice Address - Phone:804-554-6134
Practice Address - Fax:804-681-7102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty