Provider Demographics
NPI:1437379294
Name:FAMILY PRACTICE SPECIALISTS OF RICHMOND, PC
Entity type:Organization
Organization Name:FAMILY PRACTICE SPECIALISTS OF RICHMOND, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:SWIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-330-3335
Mailing Address - Street 1:3742 WINTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-9238
Mailing Address - Country:US
Mailing Address - Phone:804-330-3335
Mailing Address - Fax:804-320-2717
Practice Address - Street 1:3742 WINTERFIELD RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-9238
Practice Address - Country:US
Practice Address - Phone:804-330-3335
Practice Address - Fax:804-320-2717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0914020001Medicare NSC
VAC04728Medicare PIN