| Elite Faith Mobile Medical Clinic Pllc | |
|
95 Kyle Ct Gordonsville VA 22942-6249 | |
| (434) 989-0484 | |
| Not Available |
| Full Name | Elite Faith Mobile Medical Clinic Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 95 Kyle Ct, Gordonsville, Virginia |
| Authorized Official Name and Position | Andrea Shepherd (FOUNDER AND CEO) |
| Authorized Official Contact | 4349890484 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Faith Mobile Medical Clinic Pllc 95 Kyle Ct Gordonsville VA 22942-6249 Ph: () - | Elite Faith Mobile Medical Clinic Pllc 95 Kyle Ct Gordonsville VA 22942-6249 Ph: (434) 989-0484 |
| NPI Number | 1407695653 |
|---|---|
| Provider Enumeration Date | 05/20/2024 |
| Last Update Date | 05/20/2024 |
| Medicare PECOS PAC ID | 4880137728 |
|---|---|
| Medicare Enrollment ID | O20240619001499 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407695653 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
| Provider Name | Andrea K Shepherd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699255091 PECOS PAC ID: 0547514846 Enrollment ID: I20230921002797 |
David B Cox Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 N Main St, Gordonsville, VA 22942 Phone: 540-832-2211 Fax: 540-832-2293 |