Provider Demographics
NPI:1982001640
Name:VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM
Entity Type:Organization
Organization Name:VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM
Other - Org Name:MEDICAL COLLEGE OF VIRGINIA HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGEMENT ANALYST, EMERGENCY ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:JANIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-628-0800
Mailing Address - Street 1:701 E FRANKLIN ST. 9TH FLOOR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23219
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 E FRANKLIN ST FL 9
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-2505
Practice Address - Country:US
Practice Address - Phone:804-628-9429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-24
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024172076282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital