Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 402 N Main St, Kilmarnock, Virginia |
Authorized Official Name and Position | Kimberly Ralston (SYSTEM DIRECTOR) |
Authorized Official Contact | 4199965119 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 639991 Cincinnati OH 45263-9991 Ph: (804) 627-5573 | 402 N Main St Kilmarnock VA 22482 Ph: (804) 435-2651 |
NPI Number | 1073003455 |
---|---|
Provider Enumeration Date | 05/11/2018 |
Last Update Date | 10/15/2020 |
Medicare PECOS PAC ID | 8921060427 |
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Medicare Enrollment ID | O20180816002165 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073003455 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Chesapeake Hospital Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 Harris Drive, Kilmarnock, VA 22482 Phone: 804-435-8000 Fax: 804-435-8037 | |
Suzanne Souders Lcsw Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 25 Office Park Dr Ste 2, Kilmarnock, VA 22482 Phone: 804-577-0186 | |
Chesapeake Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 86 Harris Road, Kilmarnock, VA 22482 Phone: 804-435-2651 Fax: 804-435-2302 |