| Anew Divine Healthcare Llc | |
|
2913 River Rd W Ste K Goochland VA 23063-3263 | |
| (804) 658-8584 | |
| Not Available |
| Full Name | Anew Divine Healthcare Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2913 River Rd W Ste K, Goochland, Virginia |
| Authorized Official Name and Position | Amy D Norris (PRESIDENT/OWNER) |
| Authorized Official Contact | 8046588584 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anew Divine Healthcare Llc Po Box 82 Goochland VA 23063-0082 Ph: (804) 658-8584 | Anew Divine Healthcare Llc 2913 River Rd W Ste K Goochland VA 23063-3263 Ph: (804) 658-8584 |
| NPI Number | 1124719232 |
|---|---|
| Provider Enumeration Date | 05/18/2023 |
| Last Update Date | 11/17/2023 |
| Medicare PECOS PAC ID | 1052752391 |
|---|---|
| Medicare Enrollment ID | O20240516003892 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124719232 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Cynthia J Booten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003989351 PECOS PAC ID: 7416973045 Enrollment ID: I20051021000713 |
Goochland Free Clinic And Family Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1800 Sandy Hook Rd, Goochland, VA 23063 Phone: 804-556-6260 Fax: 804-556-6208 | |
Goochland Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2948 River Road West, Goochland, VA 23063 Phone: 804-556-6101 Fax: 804-556-6468 |