KIDMED SOUTHSIDE PLC NPI 1477869337

NPI Information

  • NPI: 1477869337
  • Provider Name: KIDMED SOUTHSIDE PLC
  • Classification: Clinic/Center - 261QU0200X
  • Specialization: Urgent Care
  • Entity Type: Organization
  • CLIA Number: 49D2015652
  • Address: 5021 CRAIG RATH BLVD
    BLDG IV
    MIDLOTHIAN, VA
    ZIP 23112
  • Phone: (804) 422-5437

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NPI Details

KIDMED SOUTHSIDE PLC is an urgent care clinic center in Midlothian, VA. KIDMED SOUTHSIDE PLC NPI is 1477869337. The provider is registered as an organization entity type.

The provider's business location address is:

5021 CRAIG RATH BLVD
BLDG IV
MIDLOTHIAN, VA
ZIP 23112-243
Phone: (804) 422-5437
Fax: (804) 422-5438

The provider's authorized official is Mark Adam Flanzenbaum .
The authorized official title is President/managing Partner and has the following contact phone number (804) 592-5437.

The CLIA number assigned to this NPI record is 49D2015652 - other - urgent care center with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/28/2010 and was last updated on 8/28/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QU0200XClinic/CenterUrgent CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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