COMMONWEALTH PRIMARY CARE NPI 1487011367

NPI Information

COMMONWEALTH PRIMARY CARE is a family nurse practitioner in Richmond, VA. COMMONWEALTH PRIMARY CARE NPI is 1487011367. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Commonwealth Extended Care.

The provider's business location address is:

1800 GLENSIDE DR
SUITE 103
RICHMOND, VA
ZIP 23226-769
Phone: (804) 285-7425
Fax: (804) 673-7074

The provider's authorized official is Karissa L. Hackelton .
The authorized official title is Medical Director/phyician/sharehold and has the following contact phone number (804) 285-7425.

The enumeration date for this NPI number is 1/22/2016 and was last updated on 1/22/2016.

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:

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