| Tamarack Center, Inc. | |
|
800 Euclid Ave Bristol VA 24201-3916 | |
| (276) 591-1122 | |
| (276) 591-1150 |
| Full Name | Tamarack Center, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 800 Euclid Ave, Bristol, Virginia |
| Authorized Official Name and Position | Ronald Woodrow Brill (OWNER/OPERATOR) |
| Authorized Official Contact | 2765911133 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tamarack Center, Inc. 800 Euclid Ave Bristol VA 24201-3916 Ph: (276) 591-1122 | Tamarack Center, Inc. 800 Euclid Ave Bristol VA 24201-3916 Ph: (276) 591-1122 |
| NPI Number | 1649272352 |
|---|---|
| Provider Enumeration Date | 08/12/2005 |
| Last Update Date | 04/20/2008 |
| Medicare PECOS PAC ID | 0941398002 |
|---|---|
| Medicare Enrollment ID | O20071127000066 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649272352 | NPI | - | NPPES |
| 4037985 | Other | VA | BCBS TN |
| 007727 | Other | VA | VALUE OPTIONS |
| 056271 | Other | VA | TRIGON |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 08100002356 (Virginia) | Primary |
| Provider Name | Ronald Woodrow Brill |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811065980 PECOS PAC ID: 5092791053 Enrollment ID: I20040629000788 |
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