| |
8920 Otterburn Rd Amelia Court House VA 23002-4854 | |
(804) 561-5150 | |
(804) 561-6643 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 8920 Otterburn Rd, Amelia Court House, Virginia |
Authorized Official Name and Position | April King (CEO) |
Authorized Official Contact | 4346962165 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 70 Victoria VA 23974-0070 Ph: (434) 696-2165 | 8920 Otterburn Rd Amelia Court House VA 23002-4854 Ph: (804) 561-5150 |
NPI Number | 1700099512 |
---|---|
Provider Enumeration Date | 05/08/2007 |
Last Update Date | 02/07/2024 |
Medicare PECOS PAC ID | 0648188755 |
---|---|
Medicare Enrollment ID | O20050516000658 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700099512 | NPI | - | NPPES |
010192862 | Medicaid | VA |
Southern Dominion Health System Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8631 Namozine Rd, Amelia Court House, VA 23002 Phone: 804-561-6263 |