NPIMap

Organization Active NPI

Virginia Commonwealth University Health System Authority

  • Specialty Pharmacy
  • Richmond, VA
National Provider Identifier
1790004307
Registry record updated May 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
License
4828680 Issued in VA
Legal business name
VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY
Practice address
417 N 11TH St
Room G108
Richmond, VA 23298-5002
Phone
(804) 828-6315
Fax
(804) 828-6872
NPI assigned
May 21, 2010
Last updated
May 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Dominic J Puleo
Title
Cfo
Phone
(804) 828-1295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialty Pharmacy 3336S0011X 4828680 VA Primary

Addresses

Primary practice location

417 N 11TH St
Room G108
Richmond, VA 23298-5002

Mailing address

PO Box 758997
Baltimore, MD 21275-0001

Other identifiers 1

IdentifierTypeStateIssuer
850674MedicaidVA

Other names 1

  • VCUHS Hemophila Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
Vcu Health System Autho35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

Locations

417 N 11th St
Rm G108
Richmond, VA 23298
Phone (804) 828-6315

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274400000000",
    "number": "1790004307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 758997",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212750001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 N 11TH ST",
            "address_2": "ROOM G108",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985002",
            "telephone_number": "804-828-6315",
            "fax_number": "804-828-6872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-21",
        "last_updated": "2010-05-21",
        "status": "A",
        "authorized_official_last_name": "PULEO",
        "authorized_official_first_name": "DOMINIC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "804-828-1295",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "VA",
            "license": "4828680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "850674",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VCUHS Hemophila Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.