| Emergicare Of South Boston Va Inc | |
|
1020 Bill Tuck Highway Suite 900 South Boston VA 24592 | |
| (434) 575-7555 | |
| (434) 575-5556 |
| Full Name | Emergicare Of South Boston Va Inc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1020 Bill Tuck Highway, South Boston, Virginia |
| Authorized Official Name and Position | Dante De Los Santos Bruno (CEO) |
| Authorized Official Contact | 4345757555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Emergicare Of South Boston Va Inc 1020 Bill Tuck Highway Suite 900 South Boston VA 24592 Ph: (434) 575-7555 | Emergicare Of South Boston Va Inc 1020 Bill Tuck Highway Suite 900 South Boston VA 24592 Ph: (434) 575-7555 |
| NPI Number | 1588745566 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 01/20/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588745566 | NPI | - | NPPES |
| 324614 | Other | VA | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 53781 (Virginia) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | 53781 (Virginia) | Primary |
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