| Brackenrich Family Practice, Plc | |
|
363 Woodland Street Rich Creek VA 24147 | |
| (540) 726-2375 | |
| (540) 726-3573 |
| Full Name | Brackenrich Family Practice, Plc |
|---|---|
| Speciality | Family Medicine |
| Location | 363 Woodland Street, Rich Creek, Virginia |
| Authorized Official Name and Position | Kathryn Ferguson (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Contact | 5407262375 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brackenrich Family Practice, Plc 363 Woodland Street Po Box B Rich Creek VA 24147 Ph: (540) 726-2375 | Brackenrich Family Practice, Plc 363 Woodland Street Rich Creek VA 24147 Ph: (540) 726-2375 |
| NPI Number | 1235229576 |
|---|---|
| Provider Enumeration Date | 10/16/2006 |
| Last Update Date | 02/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235229576 | NPI | - | NPPES |
| 0007995002 | Medicaid | WV | |
| 49D0231961 | Other | VA | CLIA NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Brackenrich Family Practice, Plc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 363 Woodland Street, Rich Creek, VA 24147 Phone: 540-726-2375 Fax: 540-726-3573 |