Provider Demographics
NPI:1831441781
Name:CARELON HEALTH OF VIRGINIA LLC
Entity type:Organization
Organization Name:CARELON HEALTH OF VIRGINIA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-268-5146
Mailing Address - Street 1:12900 PARK PLAZA DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-9329
Mailing Address - Country:US
Mailing Address - Phone:888-291-1358
Mailing Address - Fax:562-977-6141
Practice Address - Street 1:5620 BROOK RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227
Practice Address - Country:US
Practice Address - Phone:804-767-8400
Practice Address - Fax:804-262-5113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-02
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization