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7001 Forest Ave Suite 405 Richmond VA 23230-1726 | |
(804) 288-3079 | |
(804) 282-6159 |
Full Name | |
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Speciality | Internal Medicine |
Location | 7001 Forest Ave, Richmond, Virginia |
Authorized Official Name and Position | Wilbur Gay (CFO) |
Authorized Official Contact | 8645617672 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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8580 Magellan Pkwy Richmond VA 23227-1149 Ph: () - | 7001 Forest Ave Suite 405 Richmond VA 23230-1726 Ph: (804) 288-3079 |
NPI Number | 1417255365 |
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Provider Enumeration Date | 03/02/2011 |
Last Update Date | 09/04/2020 |
Medicare PECOS PAC ID | 8527969476 |
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Medicare Enrollment ID | O20190507002620 |
Identifier | Type | State | Issuer |
---|---|---|---|
1417255365 | NPI | - | NPPES |
C06778 | Other | VA | GROUP PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Mary Brantley Holmes Msn Whnp-bc Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8955 Wishart Rd, Richmond, VA 23229 Phone: 804-928-5596 | |
Independent Associates Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7605 Forest Ave, Ste 211, Richmond, VA 23229 Phone: 804-282-3114 Fax: 804-285-9723 | |