NPIMap

Organization Active NPI

Virginia Lice Removal, LLC

  • Other Technician
  • North Chesterfield, VA
National Provider Identifier
1790204196
Registry record updated Sep 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
Legal business name
VIRGINIA LICE REMOVAL, LLC
Practice address
1901 Huguenot Rd Ste 101
North Chesterfield, VA 23235-4311
Phone
(804) 337-3124
Fax
(804) 337-3124
NPI assigned
Sep 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2017

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

Authorized official

Name
Mr. Gerard Phillip Wolburg
Title
Ceo
Phone
(804) 387-6509

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 247200000X Primary

Addresses

Primary practice location

1901 Huguenot Rd Ste 101
North Chesterfield, VA 23235-4311

Mailing address

12605 Southwick Ter
Midlothian, VA 23113-2848
Phone (804) 387-6509

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1505606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505606400000",
    "number": "1790204196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12605 SOUTHWICK TER",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231132848",
            "telephone_number": "804-387-6509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 HUGUENOT RD STE 101",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354311",
            "telephone_number": "804-337-3124",
            "fax_number": "804-337-3124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA LICE REMOVAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-17",
        "last_updated": "2017-09-17",
        "status": "A",
        "authorized_official_last_name": "WOLBURG",
        "authorized_official_first_name": "GERARD",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "804-387-6509",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chesterfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2017; 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.