Provider Type Icon

VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER NPI 1396078135


NPI Information

NPI: 1396078135
Provider Name: VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER

Doing Business As: GLENWOOD MEDICAL CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 49D1075832

Address:
2711 BYRON ST
RICHMOND, VA
ZIP 23223
Phone: (804) 525-1818
Get Directions

VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER is a federally qualified health center (fqhc) clinic center in Richmond, VA. VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER NPI is 1396078135. The provider is registered as an organization entity type.
The provider Is Doing Business As Glenwood Medical Center.

The provider's business location address is:

2711 BYRON ST
RICHMOND, VA
ZIP 23223-313
Phone: (804) 525-1818
Fax: (804) 525-1820

The provider's authorized official is Tracy Causey .
The authorized official title is Chief Executive Officer and has the following contact phone number (804) 253-1968.

The CLIA number assigned to this NPI record is 49D1075832 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 9/11/2009 and was last updated on 5/18/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251B00000XCase ManagementNo
2261QD0000XClinic/CenterDentalNo
3261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes
4261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11396078135MEDICAIDVIRGINIA

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.