Provider Demographics
NPI:1750466363
Name:VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY
Entity type:Organization
Organization Name:VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HARLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-221-1067
Mailing Address - Street 1:PO BOX 718997
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19171-8997
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1300 E MARSHALL ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5028
Practice Address - Country:US
Practice Address - Phone:804-828-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-25
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA142-04-001OtherVIRGINIA DEPARTMENT OF BEHAVIORAL HEALTH
VAH-1875OtherVIRGINIA DEPARTMENT OF HEALTH