| Capital Area Health Network - Henderson Health Services | |
|
1500 N Lombardy St Richmond VA 23220-1711 | |
| (804) 780-0840 | |
| (804) 780-0862 |
| Full Name | Capital Area Health Network - Henderson Health Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 1500 N Lombardy St, Richmond, Virginia |
| Authorized Official Name and Position | Tracy Causey (CEO) |
| Authorized Official Contact | 8042531968 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Capital Area Health Network - Henderson Health Services 2809 North Ave Richmond VA 23222-3647 Ph: (804) 780-0840 | Capital Area Health Network - Henderson Health Services 1500 N Lombardy St Richmond VA 23220-1711 Ph: (804) 780-0840 |
| NPI Number | 1366920530 |
|---|---|
| Provider Enumeration Date | 07/31/2018 |
| Last Update Date | 11/17/2022 |
| Certification Date | 11/17/2022 |
| Medicare PECOS PAC ID | 9638064850 |
|---|---|
| Medicare Enrollment ID | O20181130001418 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366920530 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (NU) | Primary |
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