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6900 Forest Ave Suite 115 Richmond VA 23230-1701 | |
(804) 893-8710 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 6900 Forest Ave, Richmond, Virginia |
Authorized Official Name and Position | George Odell Butler (DIRECTOR OF CORP RESPONSIBILITY) |
Authorized Official Contact | 8042810271 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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6900 Forest Ave Suite 115 Richmond VA 23230-1701 Ph: (804) 893-8710 | 6900 Forest Ave Suite 115 Richmond VA 23230-1701 Ph: (804) 893-8710 |
NPI Number | 1821350323 |
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Provider Enumeration Date | 06/11/2012 |
Last Update Date | 10/24/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821350323 | NPI | - | NPPES |
1962464016 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | H1833 (Virginia) | 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 | |