Ch Va Collaborative Care Llc | |
4099 Basswood Rd Disputanta VA 23842-4517 | |
(571) 781-7001 | |
(888) 722-4282 |
Full Name | Ch Va Collaborative Care Llc |
---|---|
Speciality | Internal Medicine |
Location | 4099 Basswood Rd, Disputanta, Virginia |
Authorized Official Name and Position | Melissa M Cooke (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 9727153808 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Ch Va Collaborative Care Llc 4055 Valley View Ln Suite 400 Dallas TX 75244-5074 Ph: (972) 715-3800 | Ch Va Collaborative Care Llc 4099 Basswood Rd Disputanta VA 23842-4517 Ph: (571) 781-7001 |
NPI Number | 1184025439 |
---|---|
Provider Enumeration Date | 09/05/2014 |
Last Update Date | 02/10/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184025439 | NPI | - | NPPES |
E110 | Other | VA | MEDICARE CERTIFICATION NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |