Provider Demographics
NPI:1871636449
Name:VIRGINIA ENDOCRINOLOGY AND OSTEOPOROSIS CENTER
Entity type:Organization
Organization Name:VIRGINIA ENDOCRINOLOGY AND OSTEOPOROSIS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MOYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-423-7506
Mailing Address - Street 1:2384 COLONY CROSSING PLACE
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4280
Mailing Address - Country:US
Mailing Address - Phone:804-423-3636
Mailing Address - Fax:804-423-3637
Practice Address - Street 1:2384 COLONY CROSSING PL
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-4280
Practice Address - Country:US
Practice Address - Phone:804-423-3636
Practice Address - Fax:804-423-3637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232092174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAI21891Medicare UPIN
VAI54109Medicare UPIN
VAI21892Medicare UPIN