Basic Information
| Provider Information | |||||||||
| NPI: | 1205218328 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JAMES RIVER CARDIOLOGY, PC | ||||||||
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| OtherOrganizationName: | JRC VASCULAR LAB | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 445 CHARLES H DIMMOCK PKWY | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | COLONIAL HEIGHTS | ||||||||
| State: | VA | ||||||||
| PostalCode: | 238342970 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8045201764 | ||||||||
| FaxNumber: | 8667813220 | ||||||||
| Practice Location | |||||||||
| Address1: | 445 CHARLES H DIMMOCK PKWY | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | COLONIAL HEIGHTS | ||||||||
| State: | VA | ||||||||
| PostalCode: | 238342970 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8045201764 | ||||||||
| FaxNumber: | 8667813220 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2015 | ||||||||
| LastUpdateDate: | 06/25/2015 | ||||||||
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| AuthorizedOfficialLastName: | AMIN | ||||||||
| AuthorizedOfficialFirstName: | MITESH | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8045201964 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 0101241485 | VA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.