Basic Information
| Provider Information | |||||||||
| NPI: | 1790399202 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 800778 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 229080778 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4349240000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 590 PETER JEFFERSON PKWY | ||||||||
| Address2: | SUITE 175, ROOM172 | ||||||||
| City: | CHARLOTTESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 229114628 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4342439670 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2020 | ||||||||
| LastUpdateDate: | 09/02/2020 | ||||||||
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| AuthorizedOfficialLastName: | LISCHKE | ||||||||
| AuthorizedOfficialFirstName: | DOUGLAS | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF FINANCIAL OFFICER, UVAHEALTH | ||||||||
| AuthorizedOfficialTelephone: | 4349823485 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA | ||||||||
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| NPICertificationDate: | 08/25/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3336C0003X | Y | Suppliers | Pharmacy | Community/Retail Pharmacy |
No ID Information.