Provider Demographics
NPI:1144253444
Name:PULMONARY ASSOCIATES OF RICHMOND INC
Entity type:Organization
Organization Name:PULMONARY ASSOCIATES OF RICHMOND INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOUTHWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-591-3104
Mailing Address - Street 1:1000 BOULDERS PKWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-5545
Mailing Address - Country:US
Mailing Address - Phone:804-320-4243
Mailing Address - Fax:804-622-0552
Practice Address - Street 1:1000 BOULDERS PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-5545
Practice Address - Country:US
Practice Address - Phone:804-320-4243
Practice Address - Fax:804-622-0552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2022-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC04568Medicare PIN
VAC06900Medicare PIN
VAC00613Medicare PIN
VAC03706Medicare PIN
VAC05692Medicare PIN