| Caroline Famly Practice | |
|
102 West Broaddus Avenue Suite 200 Bowling Green VA 22427-9404 | |
| (804) 632-1030 | |
| (804) 632-1033 |
| Full Name | Caroline Famly Practice |
|---|---|
| Speciality | Clinic/Center |
| Location | 102 West Broaddus Avenue, Bowling Green, Virginia |
| Authorized Official Name and Position | Charles Allbaugh (CFO) |
| Authorized Official Contact | 4345814073 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caroline Famly Practice Po Box 220 New Canton VA 23123-0220 Ph: (434) 581-4073 | Caroline Famly Practice 102 West Broaddus Avenue Suite 200 Bowling Green VA 22427-9404 Ph: (804) 632-1030 |
| NPI Number | 1952535916 |
|---|---|
| Provider Enumeration Date | 05/06/2009 |
| Last Update Date | 12/16/2019 |
| Medicare PECOS PAC ID | 0345158432 |
|---|---|
| Medicare Enrollment ID | O20090803000392 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952535916 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Virginia Primary Care Associates Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 Courthouse Lane, Bowling Green, VA 22427 Phone: 804-633-5840 Fax: 804-633-4438 |