Basic Information
| Provider Information | |||||||||
| NPI: | 1124492905 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VIRGINIA ONCOLOGY ASSOCIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5900 LAKE WRIGHT DR | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 235021871 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7572135683 | ||||||||
| FaxNumber: | 7572135762 | ||||||||
| Practice Location | |||||||||
| Address1: | 1503B N ROAD ST | ||||||||
| Address2: | |||||||||
| City: | ELIZABETH CITY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 279093243 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2523312044 | ||||||||
| FaxNumber: | 2523311909 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2015 | ||||||||
| LastUpdateDate: | 11/18/2015 | ||||||||
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| AuthorizedOfficialLastName: | ALBERICO | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7574668683 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | VIRGINIA ONCOLOGY ASSOCIATES | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.