Provider Demographics
NPI:1801471057
Name:CENTRAL VIRGINIA MEDICAL CENTER LLC
Entity type:Organization
Organization Name:CENTRAL VIRGINIA MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:BAUCHOU
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:434-237-4831
Mailing Address - Street 1:7724 TIMBERLAKE RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-2327
Mailing Address - Country:US
Mailing Address - Phone:434-237-4831
Mailing Address - Fax:
Practice Address - Street 1:7724 TIMBERLAKE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-2327
Practice Address - Country:US
Practice Address - Phone:434-237-4831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty