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13855 Courthouse Road Dinwiddie VA 23841 | |
(804) 469-3731 | |
(804) 469-5307 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 13855 Courthouse Road, Dinwiddie, Virginia |
Authorized Official Name and Position | Jill W Seamans (CFO) |
Authorized Official Contact | 4346962165 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 70 Victoria VA 23974-0070 Ph: (434) 696-2165 | 13855 Courthouse Road Dinwiddie VA 23841 Ph: (804) 469-3731 |
NPI Number | 1124310446 |
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Provider Enumeration Date | 05/04/2011 |
Last Update Date | 02/03/2014 |
Identifier | Type | State | Issuer |
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1124310446 | NPI | - | NPPES |