| At Home Md Llc | |
|
1123 E Stuart Dr Galax VA 24333-2513 | |
| (276) 266-3149 | |
| Not Available |
| Full Name | At Home Md Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1123 E Stuart Dr, Galax, Virginia |
| Authorized Official Name and Position | Bradley Lineberry (CEO) |
| Authorized Official Contact | 2762663149 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| At Home Md Llc 1123 E Stuart Dr Galax VA 24333-2513 Ph: (276) 266-3149 | At Home Md Llc 1123 E Stuart Dr Galax VA 24333-2513 Ph: (276) 266-3149 |
| NPI Number | 1427718154 |
|---|---|
| Provider Enumeration Date | 12/21/2021 |
| Last Update Date | 12/21/2021 |
| Medicare PECOS PAC ID | 3476948381 |
|---|---|
| Medicare Enrollment ID | O20220310002954 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427718154 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LP2300X | Nurse Practitioner - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Torilyn C Quesenberry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992466106 PECOS PAC ID: 5294120549 Enrollment ID: I20220323000933 |
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