Provider Demographics
NPI:1902791353
Name:VIRGINIA TREATMENT CENTER OF LYNCHBURG PC
Entity type:Organization
Organization Name:VIRGINIA TREATMENT CENTER OF LYNCHBURG PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUPERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCORMAC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-270-6860
Mailing Address - Street 1:PO BOX 749057
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9057
Mailing Address - Country:US
Mailing Address - Phone:800-805-6989
Mailing Address - Fax:800-855-5811
Practice Address - Street 1:2250 MURRELL RD STE B
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-2159
Practice Address - Country:US
Practice Address - Phone:800-805-6989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No251S00000XAgenciesCommunity/Behavioral Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone