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14820 Lee Hwy Amissville VA 20106-4228 | |
| (571) 249-2493 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 14820 Lee Hwy, Amissville, Virginia |
| Authorized Official Name and Position | Andrew Kohler (CEO) |
| Authorized Official Contact | 5712492493 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 653 Amissville VA 20106-0653 Ph: (571) 249-2493 | 14820 Lee Hwy Amissville VA 20106-4228 Ph: (571) 249-2493 |
| NPI Number | 1336861921 |
|---|---|
| Provider Enumeration Date | 09/12/2022 |
| Last Update Date | 07/25/2023 |
| Certification Date | 07/25/2023 |
| Medicare PECOS PAC ID | 1456722081 |
|---|---|
| Medicare Enrollment ID | O20230118003148 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336861921 | NPI | - | NPPES |
| Provider Name | Andrew Kohler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568993475 PECOS PAC ID: 5991078354 Enrollment ID: I20200623000940 |
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