| Vcu Diagnostic Services Llc | |
|
520 N 12th St # 315 Richmond VA 23298-5064 | |
| (804) 828-9190 | |
| (804) 628-2001 |
| Full Name | Vcu Diagnostic Services Llc |
|---|---|
| Speciality | Dentist |
| Location | 520 N 12th St # 315, Richmond, Virginia |
| Authorized Official Name and Position | James Donald Parris (DIRECTOR, CLINICAL BUSINESS SERVICE) |
| Authorized Official Contact | 8048280789 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vcu Diagnostic Services Llc 520 N 12th St # 315 Richmond VA 23298-5064 Ph: (804) 828-9190 | Vcu Diagnostic Services Llc 520 N 12th St # 315 Richmond VA 23298-5064 Ph: (804) 828-9190 |
| NPI Number | 1003302472 |
|---|---|
| Provider Enumeration Date | 07/09/2018 |
| Last Update Date | 11/06/2018 |
| Medicare PECOS PAC ID | 8022362128 |
|---|---|
| Medicare Enrollment ID | O20181108000051 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003302472 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | (* (Not Available)) | Primary |
| Provider Name | Sarah H Glass |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1962812305 PECOS PAC ID: 6709121221 Enrollment ID: I20190102001635 |
| Provider Name | Duane Robert Schafer |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1043211899 PECOS PAC ID: 2860731676 Enrollment ID: I20190221002674 |
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